Read a roundup of health news stories from NPR for Jan. 23 - Jan. 29, 2005:
Flu Vaccine Update
Jan. 27, 2005 — Federal officials are opening access to the nation's flu vaccine stockpile. They hope more people at risk of flu complications and death will still get flu shots.
But even though there's extra vaccine, officials are bracing for another shortage of influenza vaccine during the flu season that begins next fall. They're unsure one major vaccine maker will be back in production.
This season's vaccine shortage resulted when British regulators suspended the license of one of America's only two flu vaccine makers. The company, Chiron Corporation, has not yet satisfied regulators that problems in its Liverpool plant have been eliminated.
Dr. Julie Gerberding of the Centers for Disease Control and Prevention says Chiron might not be licensed to produce flu vaccine for next season.
"If they do come back on line," she said in a teleconference, "I believe the current projections are that they would not have the production capability that they were expected to have this year."
When this season started, the shortage triggered long lines for flu shots in many places. Many people got discouraged and never got vaccinated. Others didn't see the need when the flu season turned out — so far — to be mild.
As a result, many high-risk people aren't vaccinated. Some areas of the country still don't have enough vaccine. Other areas have a surplus.
To encourage more adults to get flu shots, the government is making 4.4 million doses of vaccine available. Part of it is from a national stockpile; another part was set aside for children.
Next year, officials are planning to again target flu vaccine for Americans at high risk of complications and death. As this season has shown, that's hard to do. — Richard Knox
New HHS Secretary Confirmed
Jan. 26, 2005 — The Senate has confirmed the nomination of Michael Leavitt to head the Department of Health and Human Services.
Leavitt is the former governor of Utah and the current head of the Environmental Protection Agency. He enjoyed such bipartisan support in the Senate that members voice-voted his nomination to succeed the current HHS secretary, Tommy Thompson.
The only threatened snag to Leavitt's approval, a possible fight over drug imports, was defused when senators were promised a hearing on the subject.
Now comes the hard part. Leavitt will oversee the most delicate phases of the implementation of the 2003 Medicare prescription drug bill. The Bush administration is considered likely to propose major changes this year for the Medicaid health program for the poor.
And the Food and Drug Administration is also likely to come under the congressional microscope, as lawmakers look at whether the agency is doing enough to ensure the safety of prescription drugs. — Julie Rovner
Syphilis in 10-Year Cycle
Jan. 26, 2005 — Syphilis epidemics occur every 10 years or so. Experts think that reflects trends in sexual behavior. But a new study in this week's Nature says that's not so.
A syphilis peak in the 1970s was blamed on sexual revolution and gay liberation. In the 1980s, another epidemic got blamed on prostitution among crack-cocaine users.
Now, researchers at Imperial College in London say the rise and fall of syphilis isn't due to behavioral trends. It reflects immune fluctuations.
Humans infected with syphilis become partially immune for awhile. When many people at sexually active ages become partially immune, syphilis cases fall. But when many are susceptible again, cases rise.
The new data show epidemics in large U.S. cities rise and fall together, reflecting sex among people who travel.
Gonorrhea doesn't cycle this way because people don't become immune to it. So gonorrhea incidence is a better mirror of unsafe sex, researchers say. — Richard Knox
Leavitt Approval Expected; No Fight over Drug Imports
Jan. 26, 2005 — The Senate is expected to approve the nomination of Mike Leavitt Wednesday to head the Department of Health and Human Services.
The Senate Finance Committee unanimously approved the nomination of the former Utah governor and current head of the Environmental Protection Agency. But Leavitt's final approval was in some doubt.
Backers of legislation that would allow prescription drug imports from Canada and other countries, led by North Dakota Democrat Byron Dorgan, were planning to stall the nomination, if necessary, to force a promise of a vote from Senate Majority Leader Bill Frist (R-TN).
Now Frist and Health Committee Chairman Michael Enzi (R-WY) have promised senators Dorgan and Olympia Snowe (R-ME) a hearing on their drug import bill sometime in the next 90 days. That's prompted Dorgan to drop his threat to stall Leavitt's nomination.
Dorgan is also gaining support for his cause. Four freshmen senators — three Republicans and a Democrat — are planning to introduce their own drug import bill. — Julie Rovner
Medicaid Not Inefficient, Just Growing
Jan. 26, 2005 — Spending on the Medicaid health program for the poor grew by a third between 2000 and 2003, according to a new study in the online edition of the journal Health Affairs.
At his Senate confirmation hearing last week, Mike Leavitt, former Utah Governor and nominee to head the Department of Health and Human Services, called Medicaid inefficient. But the new study by researchers at the Urban Institute found that's not the case.
Most of the increases in Medicaid over the past three years came from a growth in enrollment, as more people qualified for aid as the economy declined.
In fact, Medicaid spending per person for acute care services rose at a slower rate than comparable spending for those with private insurance — just under 7 percent for Medicaid, compared with 9 percent for private coverage.
The Bush administration is expected to propose a cap on Medicaid spending in its budget due out next month. – Julie Rovner
Kidney Stones Linked to Obesity
Jan. 25, 2005 — Now there's another reason to control weight and weight gain. A new study in the Journal of the American Medical Association links obesity and weight gain to an increased risk of kidney stones.
Researchers from Brigham and Women's Hospital and Harvard Medical School in Boston analyzed data from three large ongoing studies of health professionals and nurses — over 240,000 men and women between the ages of 27 and 75.
Men who gained more than 35 pounds since adulthood had a 39 percent increased risk for kidney stones, compared with men whose weight did not change. Women who gained about the same amount of weight were at even greater risk — up to 82 percent higher than women who maintained their weight.
Researchers don't know exactly how weight gain affects kidney stones, but they think that larger body size changes the composition of urine, increasing the amount of calcium and thereby increasing the risk of kidney stones, which contain calcium. — Patricia Neighmond
Generic AIDS Drug Combo Approved
Jan. 25, 2005 — The Food and Drug Administration has tentatively approved the first generic alternative to costly AIDS drugs. That will stretch U.S. funds for AIDS treatment in developing countries.
The Bush administration has insisted that U.S. funds for AIDS treatment in developing countries can be used only for FDA-approved AIDS drugs. It's refused to accept the World Health Organization's approval process. That's been a sore point for activists. They've pointed out that at least three times more people could be treated with cheaper generic drugs.
Now the FDA has "tentatively" approved the first generic AIDS drug combination. Its maker, Aspen Pharmacare of South Africa, explains that "tentative" approval is given to generic drugs that can't be marketed in the United States because of patent laws.
The drug is a combination of the most widely used AIDS cocktail in a two-pill daily package. The drugs included are lamivudine and zidovudine. The company says it will charge $200 to $400 a year. — Richard Knox
Total Fat Less Important Than Type
Jan. 24, 2005 — A study finds that the kind of fat you eat may be more important than the total amount of fat you consume. The report appears in the current issue of the Archives of Internal Medicine.
Researchers from Finland examined the diets of over 1,500 middle-aged men.
They measured cholesterol and sugar levels in their blood and they recorded what types of fats the men ate. They looked at whether they ate diets high in polyunsaturated fats, commonly found in flaxseed, linseed and olive oil. They looked at consumption of omega-6 fatty acids, like those found in fish. And they looked at high-fat foods like red meat and cheese.
After 15 years, the men who consumed more polyunsaturated and omega-6 fats were three times less likely to die of heart disease than those who consumed other types of fat.
Earlier studies showed diets high in polyunsaturated fats can help lower cholesterol. Researchers say this is the first big study to find such diets can also help prevent heart disease. — Patricia Neighmond
Large Health Grant to Vaccines
Jan. 24, 2005 — The Bill and Melinda Gates Foundation has announced a $750 million grant to immunize children against infectious diseases.
The donation goes to the Global Alliance for Vaccines and Immunization, or GAVI, a consortium of government and international public health groups. The government of Norway has also announced its own $290 million grant to GAVI.
The money will go to vaccine and health programs in more than 70 countries where the average annual income is less than $1,000.
According to the World Health Organization, 1.4 million deaths a year in children under 5 are due to diseases that could have been prevented with vaccines.
Five years ago, the Gates Foundation gave $750 million to GAVI. The organization says that this money, along with other grants, has allowed it to vaccinate 4 million children against common diseases.
But Microsoft chairman Bill Gates says more is needed: "Despite the size of grants being announced, this is only the start of paying the total need for vaccine."
According to the World Health Organization, that would be another $8 billion to $12 billion over the next 10 years.
GAVI takes credit for preventing more than 670,000 deaths in children since it was launched in the year 2000. — Joanne Silberner
Editor's Note: NPR also receives funding from the Gates Foundation.
Increase Cardiac Rehab, Heart Group Says
Jan. 24, 2005 — The American Heart Association says doctors should be more aggressive in encouraging heart attack patients to exercise and follow cardiac rehabilitation recommendations, to avoid a second heart attack.
Studies show only about 20 percent of heart attack patients take part in this highly valuable rehabilitation. Lack of facilities is a major reason why.
Typical cardiac rehab includes following a low-fat diet along with nutrition counseling, as well as daily exercise in a controlled environment. Patients typically start slow and increase the time and challenge of exercise as they go.
Cardiac rehabilitation helps patients recover faster than those who don't receive it. It also helps them avoid further surgery, hospitalization and another heart attack.
But insurance often limits the number of rehab visits and the amount that's reimbursed. And the lack of reimbursement has discouraged hospitals from building rehab facilities. — Patricia Neighmond
New Strategy for Pandemic Flu
Jan. 24, 2005 — The World Health Organization is stockpiling an anti-viral drug called Tamiflu in Asia. Officials hope they can use it to stop a deadly flu pandemic before it gets started.
Over the past year, 52 people in Thailand and Vietnam have caught bird flu. Thirty-nine of them, or three-quarters, died of it.
But so far, the bird flu virus has jumped from one person to another in only two of those cases. A report in this week's New England Journal of Medicine that in those cases, the virus didn't change genetically. That means it hasn't yet acquired the traits that would allow it to spread explosively among humans.
Officials at the WHO now think if the bird flu virus does acquire those characteristics, it might happen in stages. So they've stockpiled 120,000 doses of Tamiflu, which is also known generically as oseltamivir.
They plan to rush the drug to areas experiencing the first signs of human-to-human spread of bird flu and hopefully quench the fire at its source. — Richard Knox
Abortion Restrictions Supported
Jan. 24, 2005 — President Bush and Senate Republicans are reiterating their support for more restrictions on abortion two days after the 32nd anniversary of the landmark Supreme Court decision Roe v. Wade.
Mr. Bush spoke by phone from Camp David to thousands of protesters who braved one of the coldest days of the year in Washington to participate in the annual anti-abortion March for Life. He said the country might not yet be ready to ban abortion but that much progress has been made to limit its availability.
Among other things, Mr. Bush appeared to put to rest speculation that he might relax restrictions on the destruction of human embryos to derive stem cells for research.
"We will not sanction the creation of life only to destroy it," he told the crowd.
On Capitol Hill, Senate Republicans unveiled their top 10 bills for the year. One is the Child Custody Protection Act, which makes it a crime to accompany a minor across state lines for an abortion if the girl's home state requires her parents to be notified first. The House has passed the bill several times over the past half-dozen years, but it has always failed in the Senate. — Julie Rovner
Plan B Deadline Missed
Jan. 21, 2005 — The Food and Drug Administration has missed a deadline to rule on a revised plan to sell the so-called morning-after pill without a prescription.
Last May, the FDA turned down Barr pharmaceuticals' application to sell Plan B, its emergency contraceptive product, over the counter. Plan B, which consists of two high-dose regular birth control pills, has been shown to prevent pregnancy in most cases if taken within 72 hours of unprotected intercourse.
The FDA said at the time it was concerned about the effect on girls under age 16. But officials invited the company to apply to allow Plan B to be sold without prescription to those age 16 and older, while requiring a doctor's permission for younger teenagers.
Barr applied in July, and FDA normally acts on such applications within six months. That deadline has now expired. A statement from Barr said FDA has told the company to expect a decision in "the near future." —Julie Rovner