Jumat, 22 Agustus 2008

Jump in US measles cases linked to vaccine fears

ATLANTA (AP) - Measles cases in the U.S. are at the highest level in more than a decade, with nearly half of those involving children whose parents rejected vaccination, health officials reported Thursday.

Worried doctors are troubled by the trend fueled by unfounded fears that vaccines may cause autism. The number of cases is still small, just 131, but that's only for the first seven months of the year. There were only 42 cases for all of last year.

"We're seeing a lot more spread. That is concerning to us," said Dr. Jane Seward, of the Centers for Disease Control and Prevention.

Pediatricians are frustrated, saying they are having to spend more time convincing parents the shot is safe.

"This year, we certainly have had parents asking more questions," said Dr. Ari Brown, an Austin, Texas, physician who is a spokeswoman for the American Academy of Pediatrics.

The CDC's review found that a number of cases involved home-schooled children not required to get the vaccines. Others can avoid vaccination by seeking exemptions, such as for religious reasons.

Measles, best known for a red skin rash, is a potentially deadly, highly infectious virus that spreads through contact with a sneezing, coughing, infected person.

It is no longer endemic to the United States, but every year cases enter the country through foreign visitors or Americans returning from abroad. Measles epidemics have exploded in Israel, Switzerland and some other countries. But high U.S. childhood vaccination rates have prevented major outbreaks here.

In a typical year, only one outbreak occurs in the United States, infecting perhaps 10 to 20 people. So far this year through July 30 the country has seen seven outbreaks, including one in Illinois with 30 cases, said Seward, of the CDC's Division of Viral Diseases.

None of the 131 patients died, but 15 were hospitalized.

Childhood measles vaccination rates have stayed above 92 percent, according to 2006 data. However, the recent outbreaks suggest potential pockets of unvaccinated children are forming. Health officials worry that vaccination rates have begun to fall - something that won't show up in the data for a couple of years.

The vaccine is considered highly effective but not perfect; 11 of this year's cases had at least one dose of the vaccine.

Of this year's total, 122 were unvaccinated or had unknown vaccination status. Some were unvaccinated because the children were under age 1 - too young to get their first measles shot.

In 63 of those cases - almost all of them 19 or under - the patient or their parents refused the shots for philosophical or religious reasons, the CDC reported.

In Washington state, an outbreak was traced to a church conference, including 16 school-aged children who were not vaccinated. Eleven of those kids were home schooled and not subject to vaccination rules in public schools. It's unclear why the parents rejected the vaccine.

The Illinois outbreak - triggered by a teenager who had traveled to Italy - included 25 home-schooled children, according to the CDC report.

The nation once routinely saw hundreds of thousands of measles cases each year, and hundreds of deaths. But immunization campaigns were credited with dramatically reducing the numbers. The last time health officials saw this many cases was 1997, when 138 were reported.

The Academy of Pediatrics has made educating parents about the safety of vaccines one of its top priorities this year. That's partly because busy doctors have grown frustrated by the amount of time they're spending answering parents' questions about things they read on the Internet or heard from TV talk shows.

In June, the CDC interviewed 33 physicians in Austin, suburban Seattle and Hollywood, Fla., about childhood vaccinations. Several complained about patient backlogs caused by parents stirred up by information of dubious scientific merit, according to the CDC report.

Questions commonly center on autism and the fear that it can be caused by the measles shots or by a mercury-based preservative that used to be in most vaccines. Health officials say there is no good scientific proof either is a cause. Also, since 2001, the preservative has been removed from shots recommended for young children, and it was never in the measles-mumps-rubella combination vaccine. It can still be found in some flu shots.

Brown said she wrote a 16-page, single-spaced document for parents that explains childhood vaccinations and why doctors do not believe they cause autism. She began handing it out this spring, and thinks it's been a help to parents and a time-saver for her.

"People want that level of information," she said.

At least one outbreak this year of another preventable disease was blamed on lack of immunizations. At least 17 children were sick with whooping cough at a private school in the San Francisco Bay area, and 13 were not vaccinated against the disease, which can be fatal to children.


Associated Press writer Marcus Wohlsen in San Francisco contributed to this story.


Face transplant patient can smile, blink again

LONDON (AP) - Transplanting faces may seem like science fiction, but doctors say the experimental surgeries could one day become routine. Two of the world's three teams that have done partial face transplants reported Friday that their techniques were surprisingly effective, though complications exist and more work is still needed.

"There is no reason to think these face transplants would not be as common as kidney or liver transplants one day," said Dr. Laurent Lantieri, one of the French doctors who operated on a man severely disfigured by a genetic disease.

In Friday's issue of the British medical journal Lancet, Lantieri and colleagues reported on their patient's status one year after the transplant. Chinese doctors also reported on their patient, two years after his surgery.

Last year, the French team operated on a 29-year-old man with tumors that blurred his features in a face that looked almost monstrous. They transplanted a new lower face from a donor, giving the patient new cheeks, a nose and mouth. Six months later, he could smile and blink.

The Chinese patient had part of his face ripped off by a bear. Surgeons in Xian gave him a new nose, upper lip and cheek from a donor. After a few months, he could eat, drink and talk normally, and returned home to Yunnan province in southwest China.

The patients were not identified although photos were included in the reports.

As is the case with all transplants, doctors use immune-suppressing drugs to prevent the recipient's body from attacking the donated tissue. In both face transplants, the patients started rejecting the transplanted tissue more than once. Their doctors solved the problem by juggling their medications.

The French patient now takes three pills a day to prevent rejection.

"That's less than most people with diabetes," said Lantieri, a plastic surgeon at the Henri Mondor-Albert Chenevier Hospital in suburban Paris.

Other doctors were reassured by the results.

"To be able to wean down the dosage of the medication in small amounts and relatively quickly, that is encouraging," said Dr. Bohdan Pomahac, a plastic surgeon at the Brigham and Women's Hospital in Boston.

Pomahac has permission to do a face transplant in the U.S., as do doctors at the Cleveland Clinic.

Experts have worried that if patients take lifelong anti-rejection drugs after a transplant, their cancer risk will jump. Some also predicted that rejection would destroy the face within a few years. Those fears seem to have been allayed, Pomahac said.

With three successful partial face transplants so far - including the world's first on a woman whose face was bitten off by a dog in France - doctors say that some of the surgery's initial uncertainties, like how functional the new face would be, are being answered.

For example, Lantieri's patient's face was paralyzed by tumors for more than a decade. The French team wasn't sure if nerves could grow after the transplant. But they discovered later their patient could blink, proving the brain was able to restore long-forgotten facial nerve connections.

Not everyone is convinced that face transplants are so revolutionary.

Dr. Patrick Warnke, a plastic surgeon at the University of Kiel in Germany, calls them a "dead-end road," because he doesn't think the rejection problem can be solved. Instead, he hopes to re-grow tissue from patients' own stem cells.

Still, the biggest obstacle to more face transplants may not be scientific, but social.

"When kidney transplants first began, people were reluctant to donate because there were a lot of cultural, social and religious issues," Pomahac said. "This is exactly the same scenario now."

Doctors plan to do more face transplants, but are having a hard time finding donors.

"Everyone says they would accept a face transplant if they were disfigured," Lantieri said. "The real question is, would you be a donor, or would you allow your family member to donate their face? That is the answer we need to change."



RP tells exporters

The Philippines has signaled rice exporting countries that it has ample rice stocks and will stop buying momentarily. A couple of months ago, the Philippine demand for more of the grains sent prices soaring to over $1,000 per ton. This time, price had gone down by 30 percent to a little over $730 per ton. "The Philippines has signalled that it has ample rice stocks and may stop buying," Chookiat Ophaswongse, the president of Thai Rice Exporters Association, told Reuters. "I see only Iran, which...


Read the label ... and then be very skeptical

Food labels are a lot like the headlines on magazine covers. They’re designed to catch your eye and make you buy.

Some label claims are helpful — they give factual information about what’s inside.

Others are pure hype created by marketing departments to make the product stand out from the crowd.


Struggling at a million-dollar horse stable

LITTLETON, Colo. - If you could put karma in the bank, Stan and Christine Penton would have a nice savings account.

As owners of one of the Denver area’s last remaining suburban equestrian stables for the past 13 years, the Pentons have offered programs for disabled riders, rescued wild mustangs and subsidized lessons and horses for the less fortunate among their generally well-to-do clientele. Leaders in their community and their church, they adopted two young children from Russia.

And good karma is mostly what they have to show for it. That and the $7,400 they can count as profit so far this year from the hundreds of thousands in revenue they have collected at their Normandy Farm and Stables