On this week’s Radio PA Roundtable, coverage of the U.S. Attorney General in Philadelphia, a Pennsylvania Congressman holding a natural gas field hearing in Williamsport; and a warning to parents and doctors from the CDC which says the HPV vaccine is being under-utilized.
Radio PA Roundtable is a 30-minute program featuring in-depth reporting, commentary and analysis on the top news stories of the week.
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Influenza hospitalization rates have increased sharply for people age 65 and older this month according to CDC Director Dr. Thomas Frieden. He says the elderly tend to be more vulnerable to complications.
The CDC is recommending older Americans and anyone with medical conditions that put them at a higher risk seek anti-viral medications within 48 hours of the onset of symptoms. Dr. Frieden says the drugs are effective is helping to avoid serious complications from the flu.
Dr. Frieden says people who have not been vaccinated should still consider a flu shot. He says there have been spot shortages, but there is still vaccine available. He says the original projection was that 135 million doses would be needed for the season. Not all doses have been used and manufacturers have about 10 million more doses- a total of 145 million- for the season. People who are having trouble finding a place to get vaccinated can check availability on line.
The rate of treatment with anti-viral medications has been lower than expected. The Food and Drug Administration is working to make sure medicine is available for all who need it.
Commissioner Dr. Margaret Hamburg says some temporary spot shortages have been reported of the liquid suspension of Tamiflu for children. The administration is taking steps to get more doses of a capsule for adults on the market. It can also be reformulated for children if needed. The manufacturer has been cleared to release it in outdated packaging and pharmacists are being notified that some instructions to not up to date.
It’s shaping up to be a bad year for West Nile Virus in the United States, with 47 states reporting positive samples and 38, including Pennsylvania, reporting human cases.
Texas is the hardest hit with about half of the 11 hundred human cases. Pennsylvania has 8 so far. Dr. Lyle Petersen, director of the CDC’s Division of Vector Borne Infectious Disease, says the mild winter, early spring and hot summer may be factors. More than half of the human cases have been the more serious neuro-invasive disease, including five of Pennsylvania’s cases.
The human cases in Pennsylvania have occurred in Delaware (2), Bucks, Centre, Franklin, Lancaster, Lebanon and Lehigh Counties. The state has three blood donor samples testing positive for the presence of the virus. There have been 7 positive veterinary samples, mostly involving horses and nearly 24 hundred positive mosquito samples.
The CDC is reminding people to take precautions against mosquito bites and take steps around their homes to eliminate standing water that can serve as breeding grounds for mosquitoes.
Dr. Petersen says it takes 3 to 14 days for symptoms to appear, meaning the cases reported now reflect infections from a week or more ago. He says they expect many more cases to be reported and the risk of infection will continue through the end of September.
According to the CDC, drowning is the second leading cause of death for children 14 and under and the sixth leading cause of unintentional death for all ages.
For children under age 5, swimming pools are the danger zone. For teens and young adults, open water such as lakes, rivers and the ocean present the biggest risk. Statistics show some 80% of drowning victims are male. Pennsylvania is among the top states for drowning deaths, with more than half in open water.
Robert Ogoreuc, an assistant professor at Slippery Rock University and incoming president of the National Drowning Prevention Alliance, says young children need to be closely supervised in the water and should be within the touch of an adult. He says parents need to be aware of having barriers to prevent children from getting into the pool unsupervised and they need to have an emergency action plan.
Ogoreuc says there should be a designated water watcher when children are swimming in a backyard pool. That’s an adult who will supervisor to make sure swimmers are safe and engaging in appropriate activities.
Ogoreuc says open water presents a danger because you’re often dealing with peer pressure, alcohol, and not understanding the full ramifications of the dangers of the water. He says people should swim near a life guard. If they’re not a strong swimmer, they need to use a life jacket in open water. He says all swimmers should be aware of their surroundings and know the area where they’re swimming. Rivers and streams could have drops off, a swift current or other potential hazards. Water temperature can also affect swimmers.
At the beach, rip currents are a risk. Ogoreuc says people should understand what a rip current is, what to look for and how to get out of a rip current.
To learn more about swimming safely, go to ndpa.org.
Young adults are increasing their risk for skin cancer according to a pair of studies by the Centers for Disease Control and Prevention and the National Cancer Institute.
One study finds that half of people ages 18 to 29 reported at least one sunburn in the past year despite an increase in protective behaviors, such as wearing sunscreen. The other study finds indoor tanning is still common among young adults.
Dr. Marcus Plescia, director of the CDC Division of Cancer Prevention and Control, says some young people may not be using sunscreen properly and may have a false sense of security when they use it, staying in the sun longer than they should. He says sometimes people are not aware they need to apply sunscreen frequently. There’s a perception you put it on, and it’s good for the day, which he says is not accurate.
Dr. Plescia also agrees young people may not be wearing sunscreen and taking protective measures during common outdoor activities. He says people have come to know when you’re sitting in the beach in blazing sun, you need to use sunscreen or wear protective clothing.
Dr. Plescia says this is the age group where, if they have the exposures while they’re young, they’re more likely to develop skin cancer. He says malignant melanoma is a deadly form of skin cancer, one they’re most concerned about preventing.
Dr. Plescia says there’s also great concern about tanning bed use. He says it’s a significant risk for cancer, because tanning beds are considered a carcinogen.
The study found almost one-third of women ages 18 to 25 used tanning beds regularly over the last year. Among white adults who report indoor tanning, 58% of women and 40% of men used one 10 or more times in the previous year.
Dr. Plescia says the incidence of malignant melanoma is actually higher among men than women.
Skin cancer is the most common form of cancer in the U.S.
State lawmakers are working on legislation to protect youth athletes from complications of concussions. A new report from the Centers for Disease Control and Prevention shows more kids are ending up in the emergency room for head injuries.
A review of emergency department visits for sports and recreation-related traumatic brain injuries, including concussions, shows an increase of 62% for kids up to age 19 between 2001 and 2009.
Dr. Julie Gilchrist, co-author of the study, says common activities were involved, including bicycling, football, basketball and soccer. Officials believe much of the increase occurred because more adults realized the youngsters needed to be seen by health care providers.
Boys between the ages of 10-19 were most likely to wind up in the emergency department for a sports or recreation related head injury. About 70% of the injury visits were among boys.
Dr. Gilchrist , a Pediatrician, researcher, and medical epidemiologist at the CDC’s Injury Center, says for children 0-4 and 5-9, boys and girls were most commonly injured in playground and bicycling activities. She says for boys 10-19, football and bicycling were the most common activities. For girls in that age group, she says it was bicycling, basketball and soccer.
Dr. Gilchrist says there are a number of things that can be done to prevent injuries. She says a helmet or the proper safety gear, having the proper skills for the activity and obeying the rules of the sport are key. She says strength and conditioning can also affect concussion rates.
She says beyond prevention, it’s important for people to know the signs of a brain injury and to know what to do. She says a child with a suspected brain injury needs to be evaluated by a health care provider who is familiar with this type of injury. They will need both physical and cognitive rest until they have fully recovered.
The state House has passed the ‘Safety in Youth Sports Act’. It requires student athletes to be pulled from games if they show signs of a concussion. It also requires students and parents to sign a concussion awareness sheet, and coaches to complete a concussion certification course. Senate concurrence is pending.
Drunk driving has fallen to its lowest level in nearly two decades according to the Centers for Disease Control and Prevention, but officials say the numbers are still too high. Adults admitted to drinking and getting behind the wheel more than 100 million times last year. Those numbers have declined 30% in the past five years. The statistics come from a national telephone survey.
CDC Director Dr. Thomas Frieden says while there’s been real progress, drunk driving is still far too common. He says while they’re pleased fewer people report drinking and driving, it’s still far too common.
Dr. Frieden says drunk driving is a public health problem with far reaching effects. He says it puts everyone at risk, even the most responsible drivers and pedestrians.
Dr. Frieden says there are proven methods to reduce the number of drunk drivers on the roads. He says that includes sobriety checkpoints and ignition interlock devices. He says those devices are only used in about 20% of drunk driving cases. He says the CDC recommends making interlocks mandatory for all offenders.
There’s some evidence the economy may be playing a role in the decline in the number of people who admit to drinking then driving. Dr. Frieden says it’s possible that people are drinking at home more.
Gwen Bergen, Behavioral scientist for the National Center for Injury Prevention and Control, says they know there were not significant decreases in self reported drinking or in self reported binge drinking during this period.
A new Centers for Disease Control and Prevention report says most teens are not getting enough sleep at night and that brings a number of risks. Almost 70% of high school students are not getting the recommended hours of sleep on school nights according to the study based on a national Youth Risk Behavior Survey.
Lela McKnight-Eily, the study’s lead author, says the insufficient sleep can increase certain risk behaviors such as substance use, feelings of hopelessness and physical fighting.
McKnight-Eily, a clinical psychologist and epidemiologist at CDC, says there may be many factors affecting the lack of sleep. She says there’s a shift in the circadian rhythm that accompanies puberty that makes teens want to go to bed later and wake up later. She says in addition, they have increased access to technology, including cell phones, the internet, and television that’s available all night (Moms and Dads- remember when TV stations “signed off” at night?)
McKnight-Eily says lack of sleep may affect cognitive ability, perhaps leading to high risk behaviors. She adds that the substance abuse or depression could be leading to the lack of sleep, or could be a form of self-medication due to the lack of sleep. She says with obesity rising, some teens may have underlying health conditions that are affecting their sleep.
McKnight-Eily says there are ways to improve a teen’s sleep. She says having a regular sleep schedule, going to sleep in a dark and quiet environment, removing distractions from the room, avoiding caffeine and stimulating foods several hours before going to sleep and getting adequate exercise can help. She says it’s important to recognize this as a significant public health problem.
The Centers for Disease Control and Prevention has released the recommendations for the upcoming influenza season. The same three flu strains that circulated last year are expected again this year.
Dr. Carolyn Bridges, associate director for adult immunizations, National Center for Immunization and Respiratory Disease, says people will still need to get a flu shot, because levels of protective antibody against influenza viruses can decline over the course of a year. Dr. Bridges says this is especially true for the elderly, people with compromised immune systems and others who could be susceptible to complications of the flu.
Children ages 6 months to 8 years usually need two doses of the flu vaccine, at least four weeks apart, to get the best protection. But since the flu strains this year are expected to be the same as last year, the CDC says a child may only need one dose of 2011-12 vaccine, as long as they had at least one dose of the 2010-11 vaccine.
Dr Bridges says vaccination levels for health care workers have increased but have still not reached national health objectives. Rates overall were 63.5%, with coverage of 84% among physicians and 70% among nurses. But the CDC recommends all workers in health care settings be vaccinated.
Dr. Bridges says influenza vaccination protects the health care worker and reduces the risk that a patient may be exposed to the flu through contact with a health care worker. She says when vaccination is required at a health care facility; the vaccination rate was 98%. It fell to 56% in facilities were it was not required. However, they found in health care workplaces where vaccination was not mandatory, rates went up when the vaccine was offered on site at the work place, free of charge with opportunities offered more than one day.
Dr. Bridges says vaccination rates among pregnant women are just below 50%. She says pregnant women, and children less than 6 months of age, are known to be at higher risk for severe illness from influenza. She says vaccination during pregnancy has been shown to reduce the risk in the mother as well as decrease the risk of influenza and influenza hospitalization among infants in the first six months of life. Flu vaccinations are not available for children under six months of age.
Dr. Bridges says women whose medical providers offered them a flu vaccine were five times more likely to get vaccinated. But she says 4 out of 10 pregnant women did not receive an offer for a vaccination from their health care provider.
Carbon monoxide is a leading cause of unintentional poisoning in the U. S. according to a new CDC report, which finds the number of cases have been under estimated. The report included statistics from the National Poison Data System and finds about 45% of the cases reported to poison centers between 2000 and 2009 were treated on site and not in a medical facility.
Exposures occur more frequently between November and February among people in the Midwest and Northeast and most happen at home.
Dr. Jeneita Bell, CDC Medical Officer and co-author of the report says those exposed to carbon monoxide are mostly women and children, but the analysis shows men are more likely to die from CO exposure.
Dr. Bell says some data sources identify older men as being more at risk, but others identify younger men, where they engage in more activities using portable generators or carbon monoxide-emitting devices like pressure washers.
Dr. Bell says during power outages, several issues can lead to a higher risk of carbon monoxide poisoning. Using portable generators too close to a home can allow the odorless, colorless gas to seep inside. She says they also found cases where people used charcoal grills inside as sources of heat and cooking.
Dr. Bell says there are also places outside the home where people may not realize they’re at risk, such as boats with motors that produce carbon monoxide.
Dr. Bell says all homes should have a battery-powered carbon monoxide alarms. She says they should be serviced on a regular basis.
To learn more about the issue, go to http://www.cdc.gov/co/.