What Is Swine Flu? How Is Swine Flu Treated?

Swine flu (swine influenza) is a disease of pigs. It is a highly contagious respiratory disease caused by one of many Influenza A viruses. Approximately 1% to 4% of pigs that get swine flu die from it. It is spread among pigs by direct and indirect contact, aerosols, and from pigs that are infected but do not have symptoms. In many parts of the world pigs are vaccinated against swine flu.

Most commonly, swine flu is of the H1N1 influenza subtype. However, they can sometimes come from the other types, such as H1N2, H3N1, and H3N2.

The current outbreak of swine flu that has infected humans is of the H1N1 type - this type is not as dangerous as some others.

Avian Influenza (Bird Flu) can also infect pigs

Avian flu and human seasonal flu viruses can infect pigs, as well as swine influenza. The H3N2 influenza virus subtype, a virulent one, is thought to have come from pigs - it went on to infect humans.

It is possible for pigs to be infected with more than one flu virus subtype simultaneously. When this happens the genes of the viruses have the opportunity to mingle. When different flu subtypes mix they can create a new virus which contains the genes from several sources - a reassortant virus.

Although swine influenza tends to just infect pigs, they can, and sometimes do, jump the species barrier and infect humans.

What is the risk for human health?

Outbreaks of human infection from a virus which came from pigs (swine influenza) do happen and are sometimes reported. Symptoms will generally be similar to seasonal human influenzas - this can range from mild or no symptoms at all, to severe and possibly fatal pneumonia.

As swine flu symptoms are similar to typical human seasonal flu symptoms, and other upper respiratory tract infections, detection of swine flu in humans often does not happen, and when it does it is usually purely by chance through seasonal influenza surveillance. If symptoms are mild it is extremely unlikely that any connection to swine influenza is found - even if it is there. In other words, unless the doctors and experts are specifically looking for swine flu, it is rarely detected. Because of this, we really do not know what the true human infection rate is.

Examples of known swine flu infecting humans

Since the World Health Organization's (WHO's) implementation of IHR (2005) in 2007, they have been notified of swine influenza cases from the USA and Spain.

In March/April 2009 human cases of influenza A swine fever (H1N1) were first reported in California and Texas. Later other states also reported cases. A significant number of human cases during the same period have also been reported in Mexico - starting just in Mexico City, but now throughout various parts of the country. More cases are being reported in Canada, Europe, and New Zealand - mainly from people who have been in Mexico.

How does a human catch swine influenza?

• From contact with infected pigs (most common way)
• From contact with infected humans (much less common way)

In cases when humans have infected other humans close contact was necessary with the infected person, and they nearly always occurred in closed groups of people.

Can I eat pork meat and pork products?

If the pork meat and pork food products have been handled properly transmission of swine influenza to humans is not possible. Cooking pork meats to a temperature of 70C (160F) kills the virus. So the answer is YES, pork meat and pork food products are safe to eat.

Where have pigs been infected?

As swine influenza infection among pigs is not an internationally notifiable disease we cannot be completely sure. Swine influenza infection among pigs is known to be endemic in the USA. Outbreaks have also occurred in other parts of North America, South American, Europe, Africa, China, Japan, and other parts of Asia.

Is there a pandemic risk?

People who are not in close contact with pigs generally have no immunity to the swine influenza viruses - they are less likely to be able to prevent a virus infection. If the virus infects enough people in a given area, the risk of an influenza pandemic is significantly greater. Experts say it is very hard to predict what impact a flu pandemic caused by a swine influenza virus would have on the global human population. This would depend on how virulent the virus is, what existing immunity among humans there already is, plus several other factors.

Do we have a specific swine flu vaccine?

No - not for humans.

Will current human flu vaccines help protect people from swine influenza infection?

We really don't know. Influenza viruses are adapting and changing all the time. If a vaccine was made, it would have to be specifically for a current strain that is circulating for it to be effective. The WHO says it needs access to as many viruses as possible so that it can isolate the most appropriate candidate vaccine.

What are the signs and symptoms of swine influenza in humans?

They are similar to those of regular flu, and include:

• Body aches
• Chills
• Cough
• Diarrhea (less common)
• Headache
• Sore throat
• Temperature (fever)
• Tiredness (fatigue)
• Vomiting (less common)

What medications are there?

There are some drugs around that can effectively treat swine flu infection in humans - and many types of flu infections in humans. There are two main types:

• adamantanes (amantadine and remantadine)
• inhibitors of influenza neuraminidase (oseltamivir and zanamivir)

Most previous swine influenza human cases recovered completely without the need for medical attention.

What can I do to protect myself?

• Wash your hands regularly with soap
• Try to stay healthy
• Get plenty of sleep
• Do plenty of exercise
• Try to manage your stress
• Drink plenty of liquids
• Eat a well balanced diet
• Refrain from touching surfaces which may have the virus
• Do not get close to people who are sick
• Stay away from crowded areas if there is a swine flu outbreak in your area

If I am infected, how can I stop others from becoming infected?

• Limit your contact with other people
• Do not go to work or school
• When you cough or sneeze cover your mouth with a tissue. If you do not have a tissue, cover your mouth and nose.
• Put your used tissues in a waste basket
• Wash your hands and face regularly
• Keep all surfaces you have touched clean
• Follow your doctor's instructions

Mexico City - Some good news

In Mexico City, where a sizeable number of people have become infected with H1N1 swine flu, authorities are urging people with flu symptoms to go straight to their doctors or a local hospital. They insist that the flu is completely treatable if the patient comes in straight away.

What is Swine Flu - Video

The Centers for Disease Control and Prevention (CDC) Influenza Division has produced a video all about swine flu.

This video includes information on the signs and symptoms of swine flu, how swine flu is transmitted, what medicines are available to treat it and steps that people can take to help protect themselves from it. There are also some tips on what to do if you become ill with swine flu.


Video by Centers for Disease Control and Prevention (CDC)

Resources: http://www.medicalnewstoday.com/articles/147720.php

Human Swine Flu Conference To Be Held In Washington DC Next Week

Tribal, local, state, federal and other leaders in the field will share best practices and current research with more than 700 delegates already registered, including participants from 32 countries at the International Swine Flu Conference. Priority will be placed on identifying the responsibilities of various stakeholders in order to improve global communication coordination and collaboration. ISFC will be held at the Hyatt Regency Washington DC on Capitol Hill, August 19-20 and will be followed by all day hands-on workshops on the 21st.

"It is with great pleasure that we look forward to welcoming our international colleagues," said Ahmed Farajallah, senior vice president, events and conferences, New Fields. "Improving global communication and collaboration is our major objective."

The ongoing Swine Flu pandemic proved that now more than ever health, education, government, non-profit organizations, and business executives need to focus, discuss and share best practices and lessons which will be learned during this first pandemic in the age of globalization.

Each day of the conference will offer papers on a wide range of topics including:

• Preparing Community Strategies
• Local Partnership and Participation
• Delivery of Vaccine and Antiviral Medication
• Emergency Response and Hospital/Healthcare Coordination
• Prevention Education Efforts and Risk Communication
• Command, Control and Management
• Business Community's Role

Panel Discussions include:

• Clinical Picture: Country Report & Situation Update
• Clinical Picture: Impact of US Export Regulations on International Cooperation in the H1N1 Pandemic Flu Response
• Risk Communication, Prevention Education Efforts and Risk Communication
• Understanding the Connection Between Human and Animal Disease, Exploring One World, One Health
• Vaccines delivery

Over 20 breakout sessions will be offered addressing a wide range of issues, including:

• Breakout-Agricultural Perspective: Socio-Economic Impact on Swine Industry
• Breakout: Schools/University Planning: How and When to Close Schools
• Breakout: Mass Fatality Management Planning
• Breakout: Business Continuity Planning, "Pandemic Showstoppers: What leads to Success or Failure at the local Community level"
• Breakout: School Emergency Preparedness
• Breakout: Hospital and Emergency Medical Services
• Breakout- COOP and Continuity of Government Planning: "Gearing up for the Fall: Rapid Training & Exercises for Health Department Staff & Partners"
• Breakout-Business Continuity: Preparing the Community for a Severe H1N1
• Breakout-Business Continuity: Global Pandemic Planning at Visa
• Breakout: Schools/University Planning: The Uniqueness of Planning for Swine Flu in Higher Education: We are Much Different than the k-12 System
• Prevention of Schools for Students, School Personnel, Parents and Communities
• Breakout: Emergency Management: States Perspective and Strategy for Pandemic Influenza- Command, Control and Management
• Breakout-Hospital& Emergency Medical Services: Impact of Swine Flu on Emergency Medical Services
• Breakout-Community-Based Planning, Community Preparedness
• Breakout: COOP & Continuity Government Planning and many more…

Workshops include:

• Learn How to Plan- Contingency Scenario Exercise for Pandemic Influenza
• Protect Your Community
• Enhancing Pandemic Preparedness Through Volunteer Resources
• Know How to Respond
• Plan to Continue

Registration:

The 2-day event is open to all interested governmental agencies, organizations, and businesses from all countries. To register, download a registration form: http://www.new-fields.com/isfc/registration.pdf.

Resources: http://www.medicalnewstoday.com/articles/160408.php

Rapid Tests for Detecting H1N1 Flu Not Reliable

Posted by Madeline Ellis on 7 Aug 2009

Officials estimate that since its emergence in early April, the H1N1 flu has infected as many as a million Americans. Its symptoms, which are similar to those of seasonal flu, may include fever, headache, coughing, sneezing, sore throat, and muscle or joint pains, which can last up to a week. A significant number of people who have been infected with the virus have also reported diarrhea and vomiting. Antiviral drugs such as Tamiflu and Relenza have been found effective at treating and reducing the duration of the illness, usually by a day or two. But in order to be most useful, they must be administered within 12 to 48 hours of symptoms onset. That could be a problem considering that identifying the virus by traditional cell culture can take days, and the rapid detection tests that can provide results in 30 minutes or less fail to identify H1N1 more than half the time, according to a new government report.

The Centers for Disease Control (CDC) studied tests using clinical specimens that had been shown to contain an influenza virus through laboratory testing from three companies: Binax Inc., Becton, Dickinson & Co., and Quidel Corp. Of the three, the Quidel test fared the best, detecting 69 percent of the infections. The Becton, Dickinson test detected 49 percent and the Binax test detected 40 percent. All tests detected seasonal flu better than the H1N1 virus. “These findings indicate that, although a positive (rapid detection test) result can be used in making treatment decisions, a negative result does not rule out infection with novel influenza A (H1N1) virus,” the authors wrote.

These findings are not entirely unexpected. A recent study in the Journal of Clinical Virology found that one test detected only 10 percent of H1N1 infections, and a second detected only 40 percent. The rapid tests “are missing a ton of flu” that could be picked up by a more sophisticated laboratory culture, said Christine C. Ginocchio, director of the division of microbiology, virology and molecular diagnostics at the North Shore-Long Island Jewish Health System in Lake Success, N.Y. And in a letter to the New England Journal of Medicine in June, Navy researchers described the poor sensitivity of the Quidel tests, pointing out that they detected only half of the infections picked up by a more sensitive technique.

However, the manufacturers of the tests argue that their products are helpful if used appropriately. Senior vice president for clinical and regulatory affairs at Quidel Corporation, John D. Tamerius, says that Quidel’s QuickVue flu test for the detection of Influenza Virus type A and type B antigens could detect 80 percent of infections if done directly from a self administered nasal specimen swab taken correctly and if the test was given early in the course of the disease, when more virus was present. “When these tests are used properly, the performance is very, very good,” Tamerius said.

Last week the CDC updated guidance urging caution in relying on the tests, fearing that the negative readings might prevent health care providers from treating patients with antiviral drugs, particularly those at high risk, such as pregnant women and those with asthma or other underlying medical conditions like heart disease and diabetes.

Resources: http://www.healthnews.com/alerts-outbreaks/rapid-tests-detecting-h1n1-flu-not-reliable-3543.html

Scientists Find New Human HIV From Gorillas

Posted by Catharine Paddock on 2 August 2009

Scientists who found a new human immunodeficiency virus (HIV) in a Cameroonian woman living in Paris, have discovered it is an unusual variant of HIV-1 that could have come from gorillas.

The research that led to the findings was headed by Dr Jean-Christophe Plantier of the University of Rouen in France and is published in the 2 August online issue of Nature Medicine. Drs David Robertson and Jonathan Dickerson from the Faculty of Life Sciences at The University of Manchester, UK, were also involved in the study.

There are three established lineages of HIV-1, known as M, N, and O, which came from chimpanzees, but this new variant appears to be the prototype of a new lineage derived from gorillas and shows no evidence of recombination with the other known lineages, wrote the researchers.

They propose that the new lineage be called HIV-1 group P.

There are 33 million people worldwide living with AIDS which is caused by the HIV-1 virus group M (groups N and O are mainly confined to Cameroon).

HIV is a product of cross-species transmission of Simian Immunodeficiency Virus (SIV) found in chimpanzees, thought to have crossed to humans from eating infected bush meat.

While first recognized in 1980, HIV is thought to have started some 80 years earlier in and around the African country that is now called the Democratic Republic of Congo.

The 62-year old Cameroonian woman at the centre of the study moved to Paris in 2004 and began to have symptoms shortly afterwards. Her blood sample showed discrepancies in her viral load, and further tests revealed she was infected with a new strain of HIV that more closely resembled SIV from gorillas than HIV from humans.

However, before moving to Paris the woman had lived in a semi-urban part of the central west African Republic of Cameroon; she had not come into contact with bush meat or gorillas.

Because of this information and the fact further tests showed that the virus was able to replicate in human cells, the scientists suggest the strain may well appear elsewhere.

Robertson told the media that:

"The discovery of this novel HIV-1 lineage highlights the continuing need to monitor closely for the emergence of new HIV variants."

"This demonstrates that HIV evolution is an ongoing process. The virus can jump from species to species, from primate to primate, and that includes us; pathogens have been with us for millions of years and routinely switch host species," he added.

In the same way as the current swine flu pandemic is showing us, this is another example of how viruses can now move very quickly around the world because nowadays large numbers of humans travel long distances in a short space of time.

Plantier's team in France are part of a network of laboratories that has been monitoring HIV genetic diversity, while the The Manchester Life Sciences team helped with the computer-based evolutionary analysis.

"A new human immunodeficiency virus derived from gorillas."
Jean-Christophe Plantier, Marie Leoz, Jonathan E Dickerson, Fabienne De Oliveira, François Cordonnier, Véronique Lemée, Florence Damond, David L Robertson & François Simon.

Resources: http://www.medicalnewstoday.com/articles/159623.php

Could Migraine Pain be Permanently Erased by Plastic Surgery?

Posted by Allie Montgomery on 3 August 2009

Have you ever had a headache so bad that you want to crawl back in the bed and hide under the covers? Well, you are not alone. Migraines are a debilitating pain that affect approximately 10 percent of the population, which is 30 million people in the United States alone. Nearly one in four households have someone that is afflicted by migraines.

For many patients, the normal over the counter medications just don’t work. Dr. Lawrence Newman, who is the director of the Headache Institute at St. Luke’s-Roosevelt Hospital In New York, said, “There is a subset of patients who have what we call chronic migraines. Many of those people are quite treatment resistant. Why? We’re not really sure. I tell our patients it is a life-altering condition. Having a migraine interferes with the person’s life, their family members, their friends, their co-workers.”

But now there may be hope for patients with migraines from a common plastic surgery procedure that was a discovery stumbled upon by accident by Dr. Bahman Guyuron, who is the chairman of the Department of Plastic Surgery at University Hospitals Case Medical Center in Cleveland. Guyuron stated, “I operated on a patient who came for a follow-up after a forehead life. Not only did she like the way she looked, she didn’t have migraines headaches for six months since the surgery.” Other patients that suffered from migraines before the surgery told him the same thing, that the forehead life had made their migraine pain disappear.

While the origins of these type of headaches are often a mystery, the research shows that the irritation of certain nerves in the face by nearby muscles might be to blame for some of the cases. Guyeron said that it would explain the improvement that his patients reported following their procedure because what he does is remove the muscles in the forehead that pinch the nerve.

Doctors have also noted that the patients that were treated with Botox often reported they had migraine relief. The researchers believe the Botox relieves the source of the migraines by paralyzing the muscles that surround the facial nerves. The next question is, could the forehead lift surgery offer a more permanent solution?

In Guyron’s small, double-blind study, he treated the patients with migraines either with an operation that targeted three common areas the trigger migraines, or a fake “sham” surgery, which acted as a control for the study. A year after the surgery took place, approximately 57 percent of the patients in the actual surgery group reported the complete elimination of their headaches, while only 4 percent of the sham surgery group did.

Some of the pain specialists that were not affiliated with the research said that the results were encouraging. Dr. Richard Lipton, who is the director of the Montefiore Headache Center in New York, noted that this study provides, “fascinating and promising results” that could benefit the patients that have high levels of pain and disability for whom other migraine treatments have failed.

However, some of the doctors said that the research findings may not be as conclusive as they appear at first look. While approximately 83 percent of the actual surgery group had a significant reduction in their migraine symptoms, so did approximately 57 percent of those that received the sham surgery.

Dr. Joel Saper, who is the director and founder of the Michigan Headache and Neurological Institute in Ann Arbor, Michigan, found that this high placebo response rate to the surgery is very troubling. “Overall, the study raises more doubts than provides answers. Surgery should be a last resort,” he stated.

Dr. Robert Shapiro, who is a professor of neurology at the University of Vermont College of Medicine in Burlington, agreed that the high rate of the patients who appeared to have improved through receiving the “sham” treatment suggested that the technique needs to be studied further. “It would be unfortunate if large numbers of migraines sufferers underwent expensive and potentially hazardous surgery which was actually no more effective than sham surgery. This study does not allow a conclusion to be drawn about the effectiveness of the surgeries performed.”

Resources: http://www.healthnews.com/family-health/could-migraine-pain-be-permanently-erased-plastic-surgery-3525.html

New Study Finds Organic Doesn’t Mean More Nutritious

Posted by Madeline Ellis on 31 July 2009

Organic food, which was once only available in small stores or farmers’ markets, is now the fastest growing sector of the American food marketplace, despite its higher costs. In 2008, the value of retail sales of organic food was estimated to be more than $28 billion, up from $1 billion in 1990. And, according to the Food Marketing Institute, more than half of Americans now buy organic food at least one a month. So why this surge in popularity? Why pay more for food because it’s organically grown? Do organic foods offer more nutritional value than their traditionally grown counterparts?

Whether or not organically grown foods are more nutritious has become a hotbed of debate, and the answer would likely depend on who one asked. For instance, The Organic Center (TOC), a pro-organic nonprofit research organization in Foster, Rhode Island recently concluded that organic foods, on average, offer a 25 percent higher nutrient level over conventional ones. And researchers at University of California at Davis claim to have found higher levels of nutrients in organic tomatoes, kiwifruit, corn, and strawberries grown side-by-side with conventional versions.

On the opposite side of the fence are major health organizations like the American Dietetic Association and the Mayo Clinic that hold an organic label is no assurance that a food is nutritionally superior, which is the same conclusion recently reached by a group of British researchers after reviewing 50 years of published data on the topic. The review, commissioned by Britain’s Food Standards Agency (FSA) and conducted by the London School of Hygiene and Tropical Medicine, found that organic food contained no more nutritional value than food grown traditionally.

Overall, the researchers found no differences of most nutrients, including vitamin C, calcium and iron, in organically or traditionally grown crops. The same was true for meat, dairy and eggs. There were differences in nitrogen and phosphorus levels, but the researchers said this was likely due to the differences in fertilizers and the ripeness at harvest, and likely provided no health benefits. “Our review indicates that there is currently no evidence to support the selection of organically over conventionally produced foods on the basis of nutritional superiority,” said Dr. Alan Dangour, study author and registered public health nutritionist.

“It is good to see that a systematic review of the literature supports what has long been believed—that the nutritional content of traditionally grown foods and organic foods are comparable,” said Connie Diekman, director of university nutrition at Washington University in St. Louis and past president of the American Dietetic Association. “This report provides confirmation for consumers that if they choose conventionally grown foods or organic foods they will be meeting their nutritional needs.”

However, others were disappointed with the findings, criticizing the study for failing to examine the impact of pesticides and herbicides, the use of antibiotics or the environmental issues. They are calling for better research. “You have to also look at what you’re not getting” with organic foods, said Sheah Rarback, director of nutrition at the Mailman Center for Child Development at the University of Miami Miller School of Medicine. “We know that young children are getting the nutrition, whatever choice they make, but we also have to look at the pesticide issue.”

Dr. Dangour admitted that “there is a possibility that organic food has less pesticide residues, but this was not part of the review.” He said that, as a nutritionist, he was not qualified to look at pesticides, but “this may be an area for further research.”

Gill Fine, the FSA’s director of consumer choice and dietary health, said the study was about ensuring people have accurate information in order to make informed choices about the food they eat. “This study does not mean that people should not eat organic food,” she said. “What it shows is that there is little, if any, nutritional difference between organic and conventionally produced food and that there is no evidence of additional health benefits from eating organic food.”

Resources: http://www.healthnews.com/nutrition-diet/new-study-finds-organic-doesn-t-mean-more-nutritious-3513.html

Tanning Beds Deemed Deadly Cancer Risks

Posted by Drucilla Dyess on 30 July 2009

The pursuit of the perfect tan could be much more costly than you think. According to experts from the International Agency for Research on Cancer (IARC) in Lyon, France, tanning beds and other sources of ultraviolet radiation carry a cancer risk that is equivalent to cigarettes. The IARC, a part of the World Health Organization (WHO), has now re-classified UV tanning beds to the highest possible cancer risk category known as "carcinogenic to humans."

Scientists have long suspected that tanning beds and ultraviolet radiation were probable carcinogens, and the results of the recent analysis performed by IARC offer proof that this is true. The analysis reviewed about 20 studies to reach the conclusion that the risk of skin cancer is increased by 75 percent when individuals use tanning beds prior to reaching the age of 30.

Although it was previously believed that only one type of ultraviolet radiation was lethal, the experts also discovered that all types of ultraviolet radiation caused disturbing mutations in mice, offering more proof that the radiation is carcinogenic. The research was published online in the medical journal Lancet Oncology.

The new classification puts tanning beds and other sources of ultraviolet radiation in the same top cancer risk category as tobacco, the hepatitis B virus and chimney sweeping, which are all known to be definite causes of cancer. The IARC says that most lights that are used in tanning beds produce ultraviolet radiation that causes skin and eye cancer.

According to Vincent Cogliano, a member of the research team, “People need to be reminded of the risks of sunbeds.” He then added, “We hope the prevailing culture will change so teens don't think they need to use sunbeds to get a tan.” Cogliano also warned that all ultraviolet radiation is unhealthy, whether it comes from a tanning bed or the sun.

Dan Humiston, president of the Indoor Tanning Association (ITA) expressed doubt about the recent finding. He said, “The fact that the IARC has put tanning bed use in the same category as sunlight is hardly newsworthy.” He went on to explain, “The UV light from a tanning bed is equivalent to UV light from the sun, which has had a group 1 classification since 1992. Some other items in this category are red wine, beer and salted fish. The ITA has always emphasized the importance of moderation when it comes to UV light from either the sun or a tanning bed.”

Kathy Banks, chief executive of The Sunbed Association, a European trade association of tanning bed makers and operators, disputed the new classification. In a statement she said, “The fact that is continuously ignored is that there is no proven link between the responsible use of sunbeds and skin cancer.” She also noted that people who use tanning beds use do so less than 20 times per year.

However, as the use of tanning beds has significantly increased among people under age 30, physicians have observed a rise in the skin cancer. In fact, prior studies have shown that younger people who use tanning beds on a regular basis have an eight time greater likelihood to develop melanoma, the deadliest type of skin cancer, when compared to those who have never used them. One case in point is that melanoma is now the leading type of cancer diagnosed in Britain for Women in their twenties. Until now, the WHO warned only people younger than 18 to avoid using tanning beds.

According to Dr. Len Lichtenfeld, deputy chief medical officer at the American Cancer Society, “This new report confirms and extends the prior recommendation of the American Cancer Society that the use of tanning beds is dangerous to your health, and should be avoided.”

Instead of using a tanning bed, the American Cancer Society advises people to use bronzing or self-tanning creams. The organization has reported that in 2008, approximately 62,000 new cases of melanoma were diagnosed in the United States, with about 8,000 people losing their lives to the deadly cancer.

Resources: http://www.healthnews.com/family-health/tanning-beds-deemed-deadly-cancer-risks-3511.html

Flu Shot to Be Priority for Pregnant Women

Posted by Allie Montgomery on 29 July 2009

We all know that the swine flu has been hitting the people in the United States pretty hard, but it has been hitting women who are pregnant unusually hard. This is why they are most likely to be among the first in line to be advised to get a new swine flu shot this fall. Pregnant women account for approximately 6 percent of the U.S. flu death since this pandemic began in April, even though they only make up 1 percent of the population in the U.S.

On Wednesday, the federal vaccine advisory panel is meeting find the answer to the question of who should be the first group to get the swine flu shots when there are not enough to give everyone. At the top of the list will be health care workers, who would be very crucial to the society during a bad pandemic. However, women who are pregnant may be near the top of the list because suffered and died from the swine flu this year at disproportionately high rates.

Dr. Denise Jamieson, who is an epidemiologist with the U.S. Centers for Disease Control and Prevention, said, “Are they more at risk for sever disease?” The risk for pregnant women from the swine flu has been a hot topic in Europe, following the contentious suggestion this month by Swiss and British health officials that women should consider holding off on getting pregnant if all possible.

Most of the health officials call that advice unwarranted, but they have agreed that the health risks are very significant. In a recent report, experts from the World Health Organization found that pregnant women appear to be “at increased risk for severe disease, potentially resulting in spontaneous abortion and/or death, especially during the second and third trimesters of pregnancy.” However, the WHO has not yet recommended that pregnant women should get priority vaccinations.

As of now, the physicians are waiting to see what is decided by the Advisory Committee on Immunization Practices, whose guidance is usually accepted by the CDC and also influences physicians and coverage by insurance. For more than a 10 years, the committee has recommended that pregnant women get vaccinated for the seasonal flu, which is considered to be a serious threat to pregnant women who are healthy and young. Dr. Kevin Ault, who is an Emory University obstetrician, said that pregnant women are unusually vulnerable, especially during their third trimester, due to the changes in their immune system and lungs that make it harder for them to overcome respiratory infections.

The data from the CDC indicates that the swine flu is at least as dangerous. Of the 302 deaths in the U.S. that were attributed to the swine flue to date, the CDC has detailed information on 266 of the cases. The agency found that 15 of the 266 cases were pregnant women, or approximately 6 percent.

The first American to get the swine flu that lead to death was a pregnant woman from Texas named Judy Trunnell. She was 33 when she died May 5th after she slipping into a coma and giving birth to a health baby girl, delivered by Cesarean section.

Some of the pregnant women that get infected also have other health problems. Trunnell, for example, also suffered from asthma and the skin condition known as psoriasis. However, many of the pregnant women who died were considered to be relatively healthy, which suggests the pregnancy itself is a significant risk, stated Jamieson. “I think the whole concept that this flu only affects pregnant women with underlying medical conditions is incorrect.”

Experts believe that an effective vaccine would not only benefit the pregnant woman but also her unborn child. Infants, whose immune systems are weak after birth, should not get the flu shot until they are at least 6 months of age. So, the doctors said that whatever immunity the infants have is passed onto them by their mother.

The belief in the protective powers of a mother’s vaccination passed on to their unborn children was demonstrated in a study of women in Bangladesh that was published last year in the New England Journal of Medicine. The study found that the flu shots that were given to pregnant women reduced flu in infants by 63 percent. However, only about 15 percent of pregnant women actually get a season flue shot, the experts noted, so it is not clear exactly how many will get the new shot.

Some women avoid getting the regular flu shot because they are worried about possible risks to their unborn child, but studies have not shown that there are any increased dangers from the shot. Dr. William Schaffner, who is a Vanderbilt University flu expert, said that until recently, many obstetricians have not offered them because they choose to avoid the expense of buying the vaccines, storing them and the hassle of trying to convince reluctant patients. “Obstetricians are only now getting with the program and are growing comfortable with administering flu vaccine,” he stated.

It is still not clear that the demand for the swine flu vaccines would be much greater than the seasonal flu vaccines. The patients who are pregnant have not expressed much concern about the swine flu pandemic, said the CDC’s Jamieson, who is also an obstetrician that is seeing inner-city patients at Atlanta’s Gray Memorial Hospital.

Jamieson stated that the swine flu has not been a major concern since it is viewed as a relatively mild illness. People are worrying more about economic concerns, “how to take care of the baby, how to get food to eat and how to get safe and secure housing,” Jamison said.

So far, the CDC believes that the swine flu has likely infected more than 1 million Americans with at least 300 casualties. The United States expects to begin testing the swine flu vaccines on some volunteers this August, and predicts approximately 160 million doses may be ready to deliver by October.

Resources: http://www.healthnews.com/family-health/pregnancy-childbirth-parenting/flu-shot-be-priority-pregnant-women-3508.html

Healing a Damaged Heart Without the Need for Stem Cells

Posted by Madeline Ellis

Experts claim that once a heart is damaged, it is nearly impossible to fix. Surgical techniques can repair blood vessels and heart valves can be replaced, but once the heart muscle is damaged, there is no known way for it to heal on its own, in part because the cells called cardiomyocytes that are responsible for the development of heart muscle stop dividing and proliferating shortly after birth. However, researchers at Children’s Hospital in Boston say they have been able to restart that cell cycle and reverse heart damage in mice—without using stem cells.

What they used is known as neuregulin 1 (NRG1), a protein which is essential for the initial development of the nervous system and the heart. Beginning a week after experiencing laboratory-induced heart attacks, live mice were given daily injections of NRG1 for 12 weeks, after which they showed evidence of improved pumping function, reductions in heart muscle scar size, and an increase in heart muscle cells. They also showed no signs of heart failure, such as dilation of the heart chambers and thickening of the heart muscle. “Most of the (heart attack) related cell death had already occurred,” said lead researcher Dr. Bernhard Kuhn. “When we began the injections we saw replacement of a significant number of cardiomyocytes resulting in significant structural and functional improvements in the heart muscle.”

The ultimate goal will be to one day use NRG1 as a therapy for heart attack patients, those with heart failure or children with congenital heart defects. It may also be used in conjunction with another protein, periostin, which is found in the developing fetal heart and in injured skeletal muscle but scarce in adult hearts, identified by Dr. Kuhn and colleagues in 2007. Periostin also promoted heart muscle cell growth and improved heart function in rats, but it cannot be injected. So the researchers developed sponge-like patches that they soaked in the compound and then placed directly on the damaged area of the heart of rats. “During initial treatment, patients might receive neuregulin injections, and once they are stable and out of the ICU, they might be taken to the cath lab for the periostin patch,” Dr. Kuhn said.

But first, both treatments must be proven safe and effective in large animal and human studies. The researchers recently completed a study of periostin in pigs, which have more in common with humans than rodents do, and the protein is now in preclinical development at Children’s Hospital for future application in human patients with heart failure.

Many other researchers are also looking for ways to repair damaged heart muscle, but most of these efforts have focused on the use of stem cells. However, Dr. Kuhn says these proteins could provide another option. “Collectively, we have identified the major elements of a new approach to promote myocardial regeneration,” he said. “Many efforts and important advances have been made toward the goal of developing stem-cell based strategies to regenerate damaged tissues in the heart as well as in other organs. The work presented here suggests that stimulating differentiated cardiomyocytes to proliferate may be a viable alternative that could be developed into a simple strategy to promote myocardial regeneration in mammals.”

Professor Jeremy Pearson, British Heart Foundation (BHF) Associate Medical Director, called the new study “fascinating” and said “if the same mechanisms identified by the researchers can be shown to work in the human heart, it opens up real possibilities for new and more efficient ways to treat people with heart disease.” He added that “up until now, adult heart cells have been widely believed to be incapable of replication.”

Resources: http://www.healthnews.com/medical-updates/healing-a-damaged-heart-without-need-stem-cells-3493.html

12 Effective Steps to Quit Smoking

Posted by Jennifer Newell on 27 July 2009

It is no secret that an addiction to cigarettes is one of the toughest habits to break. While there are some people who can quit by the strength of will power alone, the vast majority of the smoking population requires the assistance of cessation aids and numerous attempts before quitting cigarettes for good. But with medical reports and statistics piling up over the years detailing the dangers of nicotine, the need to stop smoking has become more of a trend than smoking ever was.

According to some figures, there are still over 1.1 billion people in the world who smoke cigarettes. In the United States alone, nearly 20 percent of the population still claims an affinity for cigarettes, though that number has decreased by more than half since 1965. But as society puts more of a focus on healthy living and positive lifestyle choices, in addition to entire cities across America outlawing smoking in public places, people are finding the motivation to quit the habit.

Quitting cigarettes requires more than will power for most people, though. The addiction to tobacco is not only physical but mental and emotional. Smoking a cigarette becomes part of life for the addicted, and many need to completely readjust their lifestyles in order to successfully kick the habit.

The first order of business to quitting the habit is to set a date for the last cigarette, which allows the person to get rid of extra packs of cigarettes, lighters, and ashtrays, as well as begin cleaning clothes, blankets, curtains, and any other household items that retain the smell of smoke. It is important to begin the first day of non-smoking with a fresh environment and little to no remnants of the smoking lifestyle.

Setting the date also allows the person to stock up on items that may help during the first 72 hours, when nicotine still resides in the body and the cravings for a cigarette will be the strongest. A person may choose to stock up on items like nicotine gum or patches to gradually let the body know that the process has begun. It also may be helpful to gather items that will help the oral fixation, such as straws or toothpicks, chewing gum, candy or lollipops, and snack items like carrots, celery sticks, and grapes. It may also be helpful to buy extra mouthwash and dental hygiene items to keep the mouth smelling and feeling fresh.

In addition to sharing the plan with family, friends, coworkers, and neighbors, it can also be helpful to start a journal. While it will be helpful to lean on everyone involved in daily life for encouragement and support, a log of thoughts and feelings may help put the process in perspective, especially if the journal focuses on the motivations for quitting.

A complete change in daily routine might be necessary. If smoking with coffee in the morning was a habit, there may be a need to start the day with water or juice instead. If smoking after meals was the norm, it might be helpful to immediately go for a walk after meals. Some form of exercise should be integrated into daily life as well, since the body will be craving some form of adrenaline that could be found in the healthy feeling that exercise provides.

After the first few days or weeks, it can be motivational to figure out the amount of money saved from not buying cigarettes and use it to buy something fun. Whether it is something that can aid the new, healthy lifestyle or simply something rewarding, it can further prove that cigarettes were more than a physical threat to one’s life but a financial strain as well.

The most important thing to keep in mind when quitting cigarettes is that the person has more control than the cigarette or the tobacco in it. Self-control is an asset, and remembering that you are in control of your life is the key to quitting. The assistance of others and cessation aids may be integral to success, but ultimately it is the person that is in control of habits and lifestyle choices. But if it so happens that a cigarette works its way into the person’s hands and he or she falls off the wagon, there is no reason to give up the process entirely. One mistake does not ruin the plan, and resuming the quitting process should be automatic.

It took time to become addicted to smoking, and it may take time to quit the habit. But your body, mind, pets, friends, and family will be forever grateful if the process of quitting is successful.

Resources: http://www.healthnews.com/family-health/healthnews-dozen-12-most-effective-ways-quit-smoking-3502.html

Get Happy in Two Minutes or Less

Posted by Lara Endreszl on 25 July 2009

We have all seen those individual massage chairs at outdoor concerts, inside shopping malls, or under kiosks at street markets advertising a two-minute massage at around two dollars; a small price to pay for instant stress relief and resulting happiness. If you could allow yourself two minutes for a quick dose of pure bliss everyday for practically nothing, what would you do? Some people might say they would take a cat nap, others may want an ice cream cone, and still more may think to make a phone call to a loved one. Various experts and professionals teamed up to make a list of little things you can do throughout the day to put a smile on your face:

Laugh: Visit a popular video site where you can watch clips from your favorite comedic television shows, celebrity-made skits, homemade videos, and amusing cartoons as a small pick-me-up. Find hilarious videos at websites like You Tube, Hulu, Funny or Die, etc. If you would rather get away from the computer, you can also go the personal route and ask a co-worker, friend, or relative to tell you their favorite joke.

Take a Trip…down memory lane. Open up a photo album (either handheld or an online photo site) and flip through pages of memories from your favorite summer vacation, holiday season, or weekend activity in order to spark that smile and release the dopamine in your brain that triggers euphoria.

Resist the Urge to Splurge on “things.” A panel of 329 people who indulge in shopping surveyed by a psychologist at Empire State College, admitted that buying items that alert their senses—like a concert, amusement park, museum, or massage—are generally happier then the shoppers who spend money frivolously on impulse items like shoes or clothes.

Open Up the curtains. Being near natural light a few times a day is necessary for the brain because vitamin D is crucial to determining your mood. Light researchers recommend eating breakfast near a window, opening the blinds in your bedroom when you wake up, or taking a stroll around the block during the day if the building you work in does not provide fresh light or air.

Go Nuts and eat a handful during the day. Store some walnuts in your purse, pocket, or briefcase in order to snack healthy on the go. If you are allergic or don’t like to munch on these little omega-3 fat boosters, try chunks of salmon on your lunch salad to ward off depression.

Stop & Smell something soothing. Calm-inducing scents de-stress a busy day and act as a diffuser to get your mind to stop buzzing. Simply opening a lavender candle on your desktop or filling a basket with orange, vanilla, or cinnamon potpourri can brighten your mood instantly when the scent wafts into your head.

Organize & De-Clutter your workspace. Sitting at piles of paperwork all day can make anyone feel weighed down. By purging your unnecessary papers into the recycle bin or confidentially into the shredder, you will feel great relief. Organizing your workspace—whether it’s your desktop or your kitchen tabletop—can make any process smoother. What may seem like a mundane task like chopping fruit, bread, or veggies for dinner can serve as a great way to cool down your brain to make room for an extra dose of happiness.

Next time you feel yourself pulling your hair out, rubbing your eyes against your palms, dragging your feet, or nervously tapping your fingers throughout the day, take a few minutes to close your eyes or look at a favorite photo. Next time you are at the mall and spot sit-down massage chairs offering quick relief, after these little tips you may not need any after all.

Resources: http://www.healthnews.com/family-health/mental-health/get-happy-two-minutes-or-less-3494.html

H1N1 Flu “Fastest-Moving Pandemic Ever”

Posted by Madeline Ellis on 23 July 2009

The World Health Organization (WHO) says the H1N1 flu is the fastest-moving pandemic ever, spreading as much in less than 6 weeks as past pandemic flu viruses spread in more than 6 months. Because of this rapid spread, the agency has revised its reporting requirements so that authorities need not report every case but only clusters of severe cases or deaths caused by the virus or unusual clinical patterns.

The first Mexican patient with a confirmed case of H1N1 flu said symptoms began on March 17, only 11 days before the first case on the American side of the border. The first U.S. case was in a 9-year-old girl in Imperial County, California, who got sick with a fever on Mar 28, with the second a 10-year-old boy in neighboring San Diego County who fell ill on Mar 30. By April 26, a public health emergency had been declared in the U.S. and by June 19, slightly more than a week after the WHO raised the worldwide pandemic alert to Phase 6, all 50 states in the United States, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands had reported H1N1 infection.

Since the declaration of a pandemic, at which time 70 countries had reported cases of the novel virus, the H1N1 virus has continued to spread, with the number of countries reporting cases nearly doubling. In the Southern Hemisphere, where regular flu season has begun, countries are reporting that the H1N1 virus is spreading and causing illness along with regular seasonal influenza. In the U.S., significant H1N1 illness has continued into the summer, with localized and, in some cases, intense outbreaks occurring. More than 50 summer camps in 20 states have sent kids home early or canceled sessions after suspected outbreaks.

The United States continues to report the largest number of H1N1 cases of any country worldwide—40,617 at last count. But flu experts say that in actuality at least a million Americans are infected, with as many as 500,000 in New York, where 57 of the 263 U.S. deaths have occurred. The global death toll from the H1N1 virus has doubled in the past three weeks, rising to more than 700 from about 330 at the beginning of July, the WHO said.

Given its activity to date, the Centers for Disease Control and Prevention (CDC) anticipates that there will be more cases, more hospitalizations, and more deaths associated with this pandemic over the summer, with a potential to cause significant illness into the fall and winter in conjunction with the regular influenza season. The good news, however, is that most people who have become ill have recovered within a week without requiring medical treatment.

So where do we stand on an H1N1 vaccine? The first human trials kicked off this week in the southern city of Adelaide, Australia. Vaxine began trials Monday with 300 volunteers, and CSL began a seven-month trial on Wednesday involving 240 healthy adults, ages 18 to 64, that will receive two shots at three week intervals and will undergo blood tests to determine if they are generating an appropriate immune response to the virus. Vaxine research director Nikolai Petrovsky says it will take between six and eight weeks before they know whether the vaccine is effective. “There is no guarantee any of these vaccines will work,” he said. “Swine flu is a very peculiar beast; it’s a very different virus that we’re dealing with. But we are hopeful.”

In the U.S., Dr. Kathryn Edwards, who has studied vaccinations for years, will be heading a study of the H1N1 vaccine at Vanderbilt University Medical Center in Nashville, Tennessee to determine how quickly the vaccine can get to the general public. “We will study this vaccine in people of all ages,” she said. “First we will start out in normal healthy adults.” The study will eventually expand to a larger group and will take place in the next couple of months. “We obviously will be working very rapidly to try and get as much information as possible because what we’d like to show is that it works very well in a range of patients.”
Resources: http://www.healthnews.com/alerts-outbreaks/h1n1-flu-fastest-moving-pandemic-ever-3484.html

Damaged Sperm May Be Improved Through Frequency of Sex

Posted by Neomi Heroux

Couples with fertility problems receive varying recommendations for conceiving depending on their doctor’s opinions. The medical community has long debated whether refraining from sex for several days would improve the chance of pregnancy for couples hoping to conceive. Some doctors are now recommending the best way to have a baby is to have more sex.

Research presented by Dr. David Greening of Sydney IVF, an Australian center for infertility and in vitro fertilization, indicates that increasing sexual activity may be the right approach. Dr. Greening studied 118 men with above-average sperm DNA damage. The participants were told to ejaculate every day for seven days, and the damage to their sperm count fell to 26 percent down from 34 percent. Other studies have indicated that better sperm quality results in higher pregnancy rates.

Frequent sex does decrease semen volume and it did so in the 118 participants but Dr. Greening said in a statement, “It seems safe to conclude that couples with relatively normal semen parameters should have sex daily for up to a week before the ovulation date. In the context of assisted reproduction, this simple treatment may assist in improving sperm quality and ultimately achieve pregnancy.” Sperm quality is also better in men who do not smoke, drink little, exercise and ingest more antioxidants.

Some experts believe that if sperm is in the body too long there is a higher risk of it being damaged and regular ejaculation reduces the problem by getting it out of the body quickly with less chance of DNA damage. Experts said that the research is promising, but it doesn’t prove that daily sex will actually produce more babies. Greening said that he and his colleagues are still analyzing data to determine how many pregnancies occurred in couples who had sex on a daily basis.

Not all medical professionals agreed with Dr. Greenings assumptions. Bill Ledger, a professor of obstetrics and gynecology at the University of Sheffield, and was not involved in the study, said that sperm DNA is just one part of the puzzle. This could improve pregnancy rates, but more studies need to be done. Ledger thought that the stipulation to have more sex could do more harm than good, and put pressure on couples, already under stress, to adjust their sex lives for the sake of pregnancy.

Dr. Alan Pacey, a fertility expert, also from the University of Sheffield said that the theory was interesting, but it would be wrong to apply the results to all men. Dr. Pacey said that if men suffer from low sperm counts to begin with daily ejaculations could reduce the numbers enough to impede natural conception.

One of natural effects of aging, beginning around 25 in most males, is the reduction in sperm count. Women also begin to be less fertile as they age. Whether sperm count, or sperm health holds the answer to infertility is not truly answered with this study. Doctors who chose to have their patients try this method of improving conception will probably find that their patients will take the doctor’s advice.
Resources: http://www.healthnews.com/family-health/mens-health/damaged-sperm-may-be-improved-through-frequency-sex-3392.html

Pregnancies & Sexually Transmitted Diseases on the Rise Among Teens

Posted by Drucilla Dyess on 21 July 2009

More teenagers and young adults are having sex, sparking an increase in teen births in both 2006 and 2007, and putting an end to more than a decade of significant decline. In fact, nearly three quarters of a million pregnancies occurred among American females under the age of 20 in 2004 that reversed the downward trend from 1991 to 2004.

To make matters work, sexually transmitted diseases (STDs) among young Americans are also on the rise. The annual rate of AIDS cases among boys ages 15 to 19 has almost doubled over the past decade, while the number of syphilis diagnoses are up among both teens and young adults. In addition, almost a quarter of teen girls aged 15 to 19 were infected with a human papilomavirus (HPV) from 2003 to 2004, as were almost half of young women between the ages of 20 and 25.

The troubling news comes from the Centers for Disease Control and Prevention (CDC) in their Morbidity and Mortality Weekly Report. The report was based on data compiled during the years 2002 through 2007 that was gathered from the National Vital Statistics System, the National Health and Nutrition Examination Survey, the National Survey of Family Growth and studies of hundreds of thousands children and young adults ranging in age from 10 to 25.

According to the report, the numbers indicate that the American youth is in need of better sex education that includes emphasis on STD and pregnancy prevention. In the report, the CDC writes, “The data presented in this report indicate that many young persons in the United States engage in sexual risk behavior and experience negative reproductive health outcomes.”

The report found that although more than 80 percent of boys and girls reported having received formal instruction before age 18 on how to say no to sex, among those 18 to 19 years of age, only 49.8 percent of girls and just 35 percent of boys had discussed methods of birth control with a parent. In general, nearly 70 percent of teen girls as well as 66 percent of boys reported receiving instruction on methods of birth control.

Other discoveries included that for boys ages 15 to 17, about 32 percent had engaged in sex compared to thirty percent of girls in the same age range. However, among those ages 18 to 19, almost 65 percent of boys and 71 percent of girls had experienced sex. Disturbingly, nearly 10 percent of young women ranging from 18 to 24 years reported that their first intercourse had been involuntary. About 100,000 females among the age range of 10 to 24 were treated in hospital emergency departments for non-fatal sexual assault injuries during the period between 2004 and 2006.

Among those sexually active teens, infections with the human immune deficiency virus that causes AIDS rose from 1.3 cases per 100,000 in 1997 to 2.5 cases in 2006 among boys aged 15 to 19. The syphilis rates among females aged 15 to 19 increased from 1.5 cases per 100,000 in 2004 to 2.2 cases per 100,000 in 2006 after having significantly declined between 1997 and 2005. Gonorrhea infections rates have leveled off after decreasing for more than two decades. Approximately 1 million American teens and young adults ages 10 to 24 reported contracting chlamydia, gonorrhea or syphilis in 2006, accounting for nearly half of all incident sexually transmitted diseases and 25 percent of the sexually active population.

The researchers concluded from their findings, “The sexual and reproductive health of America's young persons remains an important public health concern,” and also noted, “Earlier progress appears to be slowing and perhaps reversing."

Resources: http://www.healthnews.com/family-health/sexual-health/pregnancies-sexually-transmitted-diseases-rise-among-teens-3478.html

Circumcision Doesn’t Reduce Male-to-Female Transmission of HIV

Posted by Madeline Ellis on 19 July 09

In recent years, the male foreskin—a double-folded tube of skin and mucous membrane that covers the head of the penis—has taken center stage in the battle against HIV. The foreskin is rich in Langerhans cells, immune cells that are particularly easy for the virus to access. Following infection, these cells not only serve as reservoirs for replicating the virus, but also transport it to nearby lymph nodes where HIV spreads to other immune cells. Studies have shown that removal of the foreskin can reduce a man’s risk of heterosexually acquired HIV infection by 50 to 65 percent, findings that prompted large-scale circumcision campaigns in countries with high infection rates, such as sub-Saharan Africa, where heterosexual sex is primarily responsible for the HIV epidemic. Studies had also suggested that circumcision could reduce the rate of male-to-female transmission of the virus, but that turns out not to be the case.

A Ugandan study, led by Dr. Maria J. Wawer of Johns Hopkins Bloomberg School of Public Health in Baltimore, was stopped early after it became apparent that male circumcision offered no protection to female partners. The study involved 922 uncircumcised, HIV-infected men between 15 and 49 years of age who were randomly chosen to either be circumcised or remain uncircumcised. The HIV-free female partners of the male participants were also enrolled in the study, 90 in the circumcised group and 70 in the uncircumcised group, and their HIV status was evaluated after 6, 12 and 24 months. All participants were intensively schooled in HIV prevention and provided free condoms.

After two years, 18 percent of the women in the circumcised group had become infected with HIV, compared with 12 percent in the uncircumcised group. Cumulative probability of HIV infection at 24 months was 22 percent among women in the circumcised group and 13 percent among those in the uncircumcised group. The majority of the infections in the circumcised group occurred within the six months following the procedure. The researchers said the infections were caused because some of the men had intercourse before their circumcision wounds had healed, exposing their female partners to HIV-infected blood in the vagina.

The researchers said though they were disappointed with the outcome of the study, circumcision campaigns are still valid. “The efficacy of male circumcision for prevention of HIV in uninfected men is clear, and reductions in male acquisition of HIV attributable to circumcision are likely to reduce women's exposure to HIV-infected men. Male circumcision programs are thus likely to confer an overall benefit to women," the researchers concluded.

In an editorial accompanying the study, Dr Jared M. Baeton, from the University of Washington in Seattle, and colleagues stressed the importance of circumcision programs for men at risk of HIV, and argued for more effort being focused on people in relationships where one partner is HIV-infected and the other is not. “Prevention services for this population, including HIV testing for couples, facilitated disclosure of HIV seropositivity, and ongoing counseling services, should be a public health priority,” they write. “Such services should be incorporated into male circumcision programs, thereby providing further protection to HIV uninfected women.”

An estimated 33 million people worldwide are living with HIV/AIDS, but the World Health Organization (WHO) says circumcision has the potential to dramatically reduce the toll of the virus, averting an estimated 5.7 million new infections and three million deaths over the next 20 years in sub-Saharan Africa alone.

Resources: http://www.healthnews.com/family-health/sexual-health/circumcision-doesn-t-reduce-male-female-transmission-hiv-3469.html

What Is Eczema? What Causes Eczema?

Posted by Christian Nordqvist on 20 July 2009

Eczema is also known as atopic dermatitis, or atopic eczema (the most common form of eczema). Atopic eczema mainly affects children, but it can continue into adulthood or start later in life. The word eczema comes from the Greek word ekzein meaning "to boil out"; the Greek word ek means "out", while the Greek word zema means boiling.

Eczema is a chronic skin condition in which the skin becomes itchy, reddened, cracked and dry. Approximately 30% of all skin-related GP visits in Western Europe result in a diagnosis of atopic eczema. It affects both males and females equally, as well as people from different ethnic backgrounds. Most GPs (general practitioners, primary care physicians) in Western Europe, North America and Australia say the number of people diagnosed each year with eczema is has been rising in recent years.

Atopy is the hereditary predisposition toward developing some hypersensitivity reactions, such as hay fever, asthma, chronic urticaria, and some types of eczema. Atopic eczema, therefore, means a form of eczema characterized by atopy - in other words, inherited eczema.

Approximately 80% of atopic eczema cases start before the age of 5, and a sizeable number develops it during their first year of life.

Scottish researchers reported that children with severe eczema feel their quality of life is impaired to the same extent as those with chronic illnesses such as epilepsy, kidney disease and diabetes.

Many young children who get atopic eczema develop asthma months or years later, this is called The Atopic March. Scientists at Washington University School of Medicine in St. Louis found that a substance secreted by damaged skin circulates through the body and triggers asthmatic symptoms in laboratory mice when exposed to eczema-causing or dermatitis-causing agents, also known as allergens.

There are many types of eczema. This article focuses on atopic eczema.

What are the symptoms of eczema?

As atopic eczema is a chronic disease symptoms are generally present all the time. A chronic disease is a long-term one; one that persists for a long time. However, during a flare-up symptoms will worsen and the patient will probably require more intense treatment.

Below are some common symptoms of atopic eczema (without flare-up):

• The skin may be broken in places.
• Some areas of the skin are cracked.
• The skin usually feels dry.
• Many areas of skin are itchy, and sometimes raw if scratched a lot.
• Itching usually worse at night.
• Scratching may also result in areas of thickened skin.
• Some areas of skin become red and inflamed.
• Some inflamed areas develop blisters and weep (ooze liquid).
• The skin has red to brownish-gray colored patches.
• Areas of skin may have small, raised bumps.

Although the patches may occur in any part of the body's skin, they tend to appear on the hands, feet, arms, behind the knees, ankles, wrists, face, neck, and upper chest. Some patients have symptoms around the eyes, including the eyelids. Scratching around the eyes may eventually lead to noticeable loss of eyebrow and eyelash hairs. Babies tend to show symptoms on the face.

When there is a flare-up the previous symptoms still exist, plus some of the ones below:

• The skin will be much more itchy.
• Itchiness and scratching will make the skin redder, raw and very sensitive.
• Many of the affected areas will feel hot.
• The skin will be much more scaly and drier.
• The raised bumps will be more pronounced and may leak fluid.
• Blisters will appear.
• The affected areas may be infected with bacteria.

Flare ups can last from a day or two to several weeks.

Patients with mild atopic eczema will generally have only small areas of dry skin which may itch sometimes. When symptoms are severe large areas of skin become very dry and the itching is constant. Many areas will ooze fluid.

A vicious circle can set in. It starts with unpleasant itching, then scratching which makes the itching worse, which makes the patient scratch more - eventually the skin can bleed. Children who get into this cycle can suffer serious sleep disruption and may find concentrating at school extremely challenging.

The following may worsen the symptoms of atopic eczema:

• Prolonged hot showers or baths.
• Allowing the skin to stay dry.
• Mental stress.
• Sweating.
• Rapid temperature changes.
• Dry air.
• Certain fabrics for clothing, such as wool.
• Cigarette smoke.
• Dust.
• Sand.
• Some soaps, solvents, or detergents - a Swedish study found that linalool, the most common fragrance ingredient used in shampoos, conditioners and soap is a powerful allergen for a significant number of people.

What are the causes of atopic eczema?

Experts say that people with eczema are born with it - it is a genetically inherited condition. It can be worsened with exposure to external or environmental factors such as pollen or pet fur, and internal factors such as hormone levels and stress.

In 2006, scientists from the University of Dundee, with collaborators in Dublin, Glasgow, Seattle and Copenhagen, discovered the gene that causes dry, scaly skin and predisposes individuals to eczema.

In 2009 a study carried out by scientists at the University of Edinburgh concluded that the defects in a particular gene known as the filaggrin gene are linked to a considerably amplified risk of developing allergic disorders such as eczema, rhinitis, and asthma.

The oily (lipid) barrier of skin is usually reduced in people with atopic eczema, compared to other people. The lipid barrier helps prevent water loss. If your barrier is reduced you will lose water faster and your skin will be drier. Several studies have been confirming this, including this one.

The immune system cells of people with atopic eczema release chemicals under the skin's surface which may cause inflammation. Experts are not 100% sure why this happens. They just know that it is an immune system overreaction.

Even though scientists are fairly sure genetics are the primary cause, they do not yet know what the exact genetic cause is. The above-mentioned studies are giving us a better idea - but a great deal of further research is needed. 60% of children with atopic eczema have one parent with the same condition. Studies have shown that children run an 80% risk of developing eczema if both their parents have the condition.

Recent studies are starting to reveal a picture of early life lifestyle habits that may reduce the risk of developing eczema later on, either during early childhood or later on in life. An infant diet that includes fish before the age of 9 months curbs the risk of developing eczema, a Swedish study reported.

Environmental factors that make atopic eczema symptoms worse

Some scientists say that environmental factors are the ones causing the number of recent eczema cases in the developing world to rise. They argue that it is highly unlikely that genetic factors would change in such a short time.

Environmental factors are also known as allergens - they cause the body's immune system to overreact; an allergic reaction.

The three most common allergens for atopic eczema are:

• House dust mites (bed bugs)
• Pollen
• Pet fur - children who are exposed to cats soon after birth may have an increased risk of developing eczema, according to a study carried out by researchers at the University of Arizona in Tucson, USA.

These three allergens are also the main ones that trigger asthma and hay fever.

Hard water

Several scientists have suggested that hard water may be bad for people with eczema. Scientists from the University of Portsmouth, England, are carrying out a study to find out whether installing a water-softener in the home might improve the symptoms of children with eczema. Results of their study should appear around the end of 2009.

Foods that may make atopic eczema symptoms worse

These are foods that typically cause allergic reactions in people with sensitive immune systems. These include:

• Milk (cow's)
• Eggs
• Nuts
• Soya
• Wheat

About 10% of children with atopic eczema are affected by food allergens. Foods rarely affect the symptoms of adults with eczema.

Hormones can worsen symptoms

A significant proportion of women with eczema report that their symptoms worsen during their menstrual cycle. 30% of women have flare ups during the days preceding their menstrual period. 50% of women with eczema say their symptoms got worse when they were pregnant. These are all periods when a woman's hormone levels change.

Mental stress can make eczema symptoms worse

Doctors are not sure what exactly it is that causes a worsening of symptoms during mental stress. Atopic eczema patients commonly report that their symptoms are likely to get worse when they are mentally stressed. It is possible that a vicious cycle could develop - the symptoms of eczema stress the patient, the resulting stress exacerbates the symptoms, etc.

Winter is usually worse than summer

Most patient who do not live near the equator find that their symptoms are worse in the winter than the summer, even though pollen is an important trigger.

Diagnosis of eczema

No laboratory test or skin test currently exists which can diagnose atopic eczema.

A GP is able to diagnose atopic eczema after examining the patient and asking some questions about his/her symptoms and medical history - this will include questions about the presence of eczema in close family relative. The doctor will also ask about some other allergy-related conditions, such as asthma and hay fever.

A number of diagnostic criteria to confirm diagnosis

A doctor in the UK will assess the patient's skin against a number of diagnostic criteria in order to confirm an eczema diagnosis. The criteria include:

• A long period with itchy skin - the patient has had itchy skin for the last 12 months.

Plus at least three of the criteria below:

• Itching and irritation - itchiness and irritation in skin creases, such as the front of elbows, behind the knees, front of ankles, around the neck, or around the eyes.


• Asthma or hay fever - the patient either has asthma or hay fever or has had them in the past. If the child is under four, the doctor will ask whether a close relative (brother, sister, mother, father) has asthma or hay fever.


• Dry skin - the patient's skin has been dry for the last 12 months.


• When it started - the condition started when the patient was two years old, or less. (If the patient is under four years of age this criterion is not used).


• Joints - eczema is present either where skin covers the joints or the parts of the body that flex, such as wrists, knees, or elbows.

If the patient meets these criteria (the first, plus at least three of the others) the UK doctor will not usually have to carry out any further testing to confirm diagnosis.

Identifying trigger factors during diagnosis

The doctor will try to find out what triggers worsen the patient's symptoms. He/she will ask the patient questions about lifestyle, soaps and detergents used, diet, home environment, pets, where exactly the house is, etc.

Some doctors will ask the patient to keep a diary - the patient will note down such data as eating habits, clothes worn, what time of day symptoms are better or worse and where the patient was during those times, etc. The aim here is to identify as many trigger factors as possible.

What is the treatment for atopic eczema?

There is currently no cure for atopic eczema - there is no treatment that gets rid of it for good, as might be the case with surgery to cure blindness caused by cataracts. However, there are a variety of treatments which focus on the symptoms, as well as strategies to avoid triggers, and may improve the patient's quality of life considerably.

A significant proportion of children with atopic eczema will find that their symptoms will improve as they get older.

Self-care - What the patient can do

• Avoid scratching
  
  Itchiness is a common part of eczema, and scratching is a natural reaction to deal with itching. Unfortunately, scratching will invariably further aggravate the skin and make symptoms worse. Scratching also raises the risk of infection.
  
  Getting an adult to control his/her scratching is hard enough - it is even harder for children. Children will often not be able to control the urge to scratch. It is important that nails are kept short and clean. Babies may benefit from anti-scratch mittens.


• Avoid trigger factors
  
  A good doctor will have established a list of factors that trigger eczema flares. The patient should try to avoid them as much as possible. Parents/guardians need to remind children of triggers and help them devise strategies to avoid them - younger children may need to be reminded frequently.
  
  People with atopic eczema usually avoid clothes made of synthetic fibers and opt for natural materials, such as cotton.
  
  We know that dust mites are likely triggers for many people. However, most studies have shown that trying to eradicate them from your home is very time consuming and does not seem to be very effective in reducing the frequency and severity of flare-ups. Several patients have written into Medical News Today saying that when they get up in the morning they pull their sheets right back and do not make their beds for several hours, allowing the bed to be ventilated - this has helped them (bear in mind this information is not a study, and must be taken as anecdotal).


• Nutrition
  
  It is important to check with your doctor before undergoing any large change in diet, especially if the patient is a child. Breastfeeding mothers whose babies have atopic eczema should check with their GP before embarking on any significant diet change. Milk, eggs, and nuts are common triggers.
  
  The German Institute for Quality and Efficiency in Health Care stresses that parents should be cautious about eliminating important foods like milk from their baby's or child's diet. In fact, their report says that avoiding foods may do more harm than good for children with atopic eczema, unless your child has a proven food allergy.
  
  If you have identified the triggers you should avoid them. However, if a child's trigger is milk he/she will need an alternative source of calcium. Always check with your doctor or a qualified nutritionist first before taking a major food source out of your or a child's diet.

Complementary therapies

These are very popular among patients with atopic eczema. They include aromatherapy, massage, homeopathy, and some herbal remedies, to mention but a few. It is important to remember that although patients do report benefits, a lot of information one reads in books and on the internet is anecdotal. For therapy to be convincing, it should undergo proper clinical tests, usually carried out and compared to a placebo (dummy treatment). Before undergoing any complementary/alternative therapy, check it out carefully.

Researchers at Mount Sinai Hospital in New York reported that treatments consisting of Erka Shizheng Herbal Tea, a bath additive, creams and acupuncture, effectively treated patients with persistent atopic eczema. Their findings were presented at the 2009 Annual Meeting of the American Academy of Allergy, Asthma & Immunology.

Another study, carried out by Scientists at the Chinese University of Hong Kong, found that a traditional Chinese herbal concoction, consisting of Flos lonicerae (Japanese honeysuckle), Herba menthae (peppermint), Cortex moutan (root bark of peony tree), Atractylodes Rhizome (underground stem of the atractylodes herb) and Cortex phellodendri (Amur cork-tree bark) may help people with eczema and reduced their needs for medications.

Bleach baths

Researchers from the Northwestern University Feinberg School of Medicine reported that bleach baths offer an effective treatment for kids' chronic eczema.

Emollients

An emollient is an agent that softens and smoothes the skin - it can be a cream, lotion or ointment. They keep the skin supple and moist. Emollients are an important part of atopic eczema treatment. The skin of people with eczema is usually dry; emollients help keep them moisturized, which helps prevent cracking and irritation.

Finding the right emollient may be a question of trial-and-error at first. The patient may have to try several different ones before hitting on a suitable one. Patients usually end up needing different types of emollients for different parts of their body.

Some emollients are specific for very dry skin, while others are aimed at less dry skin. Ointments are generally prescribed for drier skin, while creams and lotions are usually prescribed for other skin types.

It is not uncommon for patients to find that an emollient is not longer as effective as it used to be. Others may start experiencing skin irritation after long-term use. If either case happens to you or your child, you should see your GP.

• Applying an emollient - apply smoothly to the skin, following the direction the hair grows. Do not rub it in as this may irritate the skin. Gently dry the skin after washing and apply the emollient as soon as the skin is dry. Emollients must not be shared.


• Creams and lotions are generally used for red, inflamed areas.


• Ointments are usually used for dry areas that are not inflamed.


• Apply often - Frequency is the key for effective emollient use. Do not stop applying it when the skin seems to be clear. Frequent use on known affected areas will significantly reduce the number of flare-ups, as well as their severity. Patient's whose skin is very dry should have repeat applications every two to three hours. During flare-ups frequency of use is paramount - this is when the skin needs the most moisture. Applications during a flare-up should be both frequent and generous.
  
  If your child has atopic eczema it is important that you liaise with his/her school. In the UK it is common for a child to have emollient supplies at home and at school.


• Emollient instead of soap - emollient treatments should be used in place of soap. Soap irritates the skin if you have atopic eczema. In many countries it is possible to purchase emollient bath and shower additives. This measure will make a significant difference in the patient's frequency and severity of flare-ups.


• Side effects of emollients - some patients may develop a rash with certain ingredients in a specific emollient. That is why people commonly have to try out different ones when they first start. Some emollients contain paraffin and can be a fire hazard - store them carefully and do not use them near a naked flame. Emollients may make the surface of the bath and the floor of the shower cubicle more slippery.

Topical corticosteroids

In medicine topical means "applied on to the skin". Corticosteroids rapidly reduce inflammation. If the patient's skin is very red and inflamed the doctor may prescribe a topical corticosteroid.

Many parents or adult patients react with alarm when the doctor utters any word with "steroid" in it. They imagine anabolic steroids that bodybuilders use. Corticosteroids are not anabolic steroids, and when used correctly, they are a safe and effective treatment for eczema.

• Applying a corticosteroid - apply to the affected area sparingly. Follow the instructions on the leaflet carefully. You can also ask the doctor, and if you cannot remember, ask a qualified pharmacist.


• Applying a corticosteroid during a flare-up - the corticosteroid should not be applied more than twice daily. Most patients will only require one application per day. After the flare-up has cleared up you should continue for another 48 hours.

If the patient is using corticosteroids on a long-term basis, he/she should check carefully with the doctor on how and when to apply it.

If you have tried corticosteroids and symptoms have not improved you should see your doctor.

Alitretinoin (Toctino)

Alitretinoin is used for patients with severe, chronic hand eczema who have not responded to other treatments. A specialist skin doctor (dermatologist) needs to supervise treatment with alitretinoin. Alitretinoin is a retinoid, a type of medication that helps lower levels of irritation and itchiness associated with eczema. Treatment usually consists of swallowing one tablet a day for 12 to 24 weeks.

Alitretinoin must NOT be taken by pregnant women or breastfeeding mothers. In most countries alitretinoin is not recommended for women of child-bearing age.

Side effects of alitretinoin include headaches, dry skin, flushed skin, joint pain, and muscle pain. The following extremely rare side-effects also exist: hair loss, blurred and distorted vision, and nose bleeds. Anybody who experiences blurred vision when taking this medication should contact the dermatologist immediately.

Antihistamines

This type of medication stops the effects of histamine, which our body releases when in contact with an allergen. If the effects of histamine can be stopped or reduced, symptoms of eczema, hay fever, and some other allergic conditions are often significantly reduced.

• Sedating antihistamines can make some people feel drowsy and are generally prescribed for itchiness at night - their drowsiness side-effect will help some patients get a good night's sleep. Sedating antihistamines are not usually prescribed for more than a couple of weeks at a time. They should be taken about one hour before going to bed. Sometimes drowsiness is still present the following day - it is important that the child's school knows this. If the patient is an adult and feels drowsy the following morning he/she should not drive or operate heavy machinery.


• Non-sedating antihistamines may be used on a long-term basis. They will help ease itching but will not make the patient feel drowsy.

Infection

If the eczema becomes infected the patient will probably need an antibiotic.

• Oral antibiotic - An oral antibiotic will be prescribed if symptoms are very severe and infection has affected a large area. The most commonly prescribed antibiotic is flucloxacillin, which should be taken for seven days. If you or your child are allergic to penicillin a different antibiotic will be prescribed, perhaps erythromycin or clarithomycin.


• Topical antibiotic - if symptoms are not so severe and the infection does not cover a large area the patient will most likely be prescribed a topical antibiotic - one that is applied directly onto the affected area. This will usually be an ointment or a cream.

The doctor may prescribe new supplies of topical medications in case your current ones have become infected.

Patients who have areas which are prone to recurrent infection may be prescribed a topical antiseptic, which is applied directly onto the targeted area of skin. Examples include chlorhexidine and triclosan.

Light Therapy (Phototherapy)

This involves the use of natural or artificial light. In its most simple form, all the patient has to do is expose himself/herself to controlled amounts of natural sunlight.

Other forms of phototherapy include using artificial ultraviolet A (UVA) or ultraviolet B (UVD) light, either on its own or in combination with drugs.

Light therapy is very effective. It is important that it is done with a qualified health care professional. Exposure to sunlight has many beneficial effects, but it does, however, also have risks if not controlled properly. Examples of risks include premature skin aging and a higher risk of developing skin cancer.

When to see a specialist

The GP may refer a patient to a specialist skin doctor (dermatologist) if:

• The patient has not responded to treatment.
• The GP is uncertain about what is causing the eczema.
• The patient insists the GP refers him/her or the child to a specialist.
• The GP thinks the patient would benefit from specialist treatment, such as ultraviolet light exposure, bandaging treatments (wet wraps), or calcineurin inhibitors.

Complications of atopic eczema

Infection

If the skin becomes dry and cracked there will be an opportunity for bacteria to penetrate. The likelihood of this happening is greater for people with eczema. Scratching the eczema increases the risk of infection further.

A bacterium called Staphylococcus aureus (S. aureus) commonly infects people with eczema. An infection with S. aureus will make the eczema much worse, causing increased redness, oozing of fluid and crusting of the skin, making it virtually impossible for the skin to heal naturally (without antibiotics).

Psychological effects

The mental stress of living with eczema can have a psychological impact on the sufferer, especially if it started very early in life. Children with atopic eczema are much more likely to have behavioral problems at school, compared to their peers who do not have it. Parents sometimes comment that their child with atopical eczema is much more clingy than their other children.

The stress can also come from other people. More than a quarter of patients with atopic eczema have been bullied or teased because of their skin condition, according to an international study.

Children with eczema frequently suffer from a lack of self-confidence. Family support and encouragement is a crucial factor in helping them overcome this. If your child's self-confidence appears to be seriously undermined, talk to a health care professional, as well as the staff at his/her school.

Sleep problems

The majority of children with atopic eczema have sleep-related problems. Lack of sleep can have an impact on the patient's physical and mental health.

Resources: http://www.medicalnewstoday.com/articles/14417.php