Doctor Housecalls Blog

Healthcare related news and updates

The Global Polio Eradication Initiative began in 1988 in order to put an end to one of the world’s most crippling diseases. The initiative is a joint effort by the World Health Organization (WHO), UNICEF, Rotary International, the U.S. Centers for Disease Control and Prevention, the Bill and Melinda Gates Foundation, and governments around the world, with the support of many others globally. So how is it going? Only three endemic countries remain and 2.5 billion children have been immunized against polio. But the fight is far from over.

In May, the WHO declared an international public emergency after outbreaks were cited in 10 countries. Travel has begun to complicate the eradication effort, causing the threat of polio to re-emerge in countries once considered polio free.

We need to step up our efforts against the fight. MSN News (AP, 8/22, Neergaard) reported on a new study released by the World Health Organization in Science Magazine stating that children who received a single vaccine shot after already receiving an oral vaccine greatly boosted their immunity. WHO has begun using the combo oral vaccine and vaccine shot strategy in mass vaccination campaigns targeting hard-hit areas. It is also being introduced in developing countries.

“It could play a major role in completing the job of polio eradication once and for all,” said Dr. Hamid Jafari of the WHO and lead study author.

The key to eradicating polio in the tough-to-reach areas is taking maximum advantage of each vaccination encounter. Inevitably that means fewer doses but the same potency. As reported by the Los Angeles Times (8/22, Healy) “Science Now” blog, “vaccination campaigns are so easily disrupted by conflict, mass migrations and rumors of medical malfeasance, getting the highest level of polio immunity with the fewest vaccine doses delivered is key.”

The WHO’s global polio eradication effort has relied heavily on the oral vaccine due to cost and ease of administering the vaccination. But as revealed in TIME (8/22, Park), places where polio is rampant, such as Northern India, the oral vaccines weren’t doing much to reduce the disease’s burden. Multiple vaccinations were being given above the recommended three doses to control the spread of the disease and limit transmission. Something better had to be done. Researchers conducted a test adding the inactive shot vaccination to the schedule. Among 954 infants and children aged five years to 10 years who had already received several doses of oral vaccine, adding a shot of the inactivated vaccine helped them shed less virus compared to those who received another dose of the oral vaccine, adding strength and longevity to their immunity.

HealthDay (8/22, Preidt), MedPage Today (8/22, Smith), and Medscape (8/22, Hand) also covered the story.

Spray-on sunscreen is quick, easy and convenient but is it safe and effective? In short, the Food and Drug Administration doesn’t even know. The safety and effectiveness of spray-on sunscreens has come under question by the FDA not only for the risk of consuming airborne particles but also for the effectiveness of the product being applied to the skin. In August, the New York Times (8/22, Saint Louis) “Well” blog responded to the safety question, highlighting concerns that harmful particles in spray-on sunscreens can spread and inhaled, or even get into one’s eyes. Recently, with the number of spray-on sunscreens increasing, the FDA is asking product makers to demonstrate their effectiveness and safety over rub on sunscreens. They are also urging product makers to add warning labels advising consumers to avoid breathing in the product and warn consumers about the risk of burns when applied near an open flame. The Environmental Working Group, an advocacy organization dedicated to promoting healthier lives for all Americans, has also responded to the issue warning consumers to avoid all spray-on sunscreens of any particle size, especially ones that use mineral ingredients like zinc oxide and titanium dioxide, which they say may pose problems if inhaled.”

Obama Administration Unveils Plan to Battle Antibiotic Resistance.

by Dr. Steven J. Lipsky MD, FACEP

Antibiotic resistance is on the rise and the Obama Administration has put together a plan to combat the issue. Major newspapers, wire services, and online healthcare-related outlets published coverage of the news conference held late last week. In a news conference, the President’s chief science advisor announced plans to improve antibiotics through new drug development; reining in antibiotic misuse and developing diagnostic testing to help doctors and veterinarians decide when antibiotics are truly needed.

John Holdren, director of the White House Office of Science and Technology Policy sees antibiotic resistance as a potential threat to not only the nation but the world. “The rise in antibiotic-resistant bacteria represents a serious domestic and international challenge to human and animal health, national security and the economy” USA Today (9/19, Weintraub).

According to Tom Frieden, MD, MPH, director of the Centers for Disease Control and Prevention, combating antibiotic resistance is vital to maintaining our current standards of medical care. “Antibiotic resistance is linked to at least 23,000 death and two million illnesses each year.” Frieden also notes that in addition to treating bacterial infections, antibiotics also help with complications arising from conditions like cancer, arthritis and asthma. “If we lose the ability to treat these, we will undermine much of our current medical care system.”

Researchers have been warning for years that antibiotics are losing their strength due to overuse. The New York Times (9/19, A16, Tavernise, Subscription Publication) reports that if this trend of overuse is not “halted, we could return to the time before antibiotics, when it was common for people to die from ordinary infections and for children not to survive strep throat.” According to Holdren, the new strategy – established by an executive order signed by the President – is intended to jolt the federal government into action to begin aggressively addressing a health crisis experts have been slow to recognize.

The President is mobilizing a special task force comprised of key federal agencies. As reported in The Los Angeles Times (9/19, Morin) “Science Now” blog, the task force, co-chaired by the secretaries of Defense, Agriculture and Health and Human Services, “will oversee public, private and academic efforts to minimize the spread of superbugs by promoting the proper use of antibiotics; the acceleration of scientific research into new antibacterial drugs and novel therapies; and the creation of new diagnostic technologies that will identify drug-resistant bacteria.” In addition, the National Institutes of Health and the Biomedical Advanced Research and Development Authority are working in conjunction with the White House to co-sponsor a contestant for the development of diagnostic testing that will rapidly identify superbugs. On the line is a $20 million prize.

The administration’s national strategy with a five-year plan calls for the new presidential advisory council to make special recommendations to the White House by February 2015. It is a strategy with a targeted goal of reducing the overall incidences of Clostridium difficile, also known as C-diff, by 50 percent, and cutting the number of methicillin-resistant Staphylococcus aureus (MRSA) infections by 2020 in half. Additionally, the President’s Council of Advisors on Science and Technology (PCAST) released a 78-page document “outlining practical steps the government can take to both track resistant germs and develop novel antibiotics to treat bacterial infections” as reported in the Washington Post (9/19, Nutt).

Critics had hoped the White House would go one step further and address the use of antibiotics in animals, particularly those used for meat. The AP (9/19, Jalonick) reported that the executive order directs the Food and Drug Administration to “to continue taking steps to eliminate agricultural use of medically important antibiotics for growth-promotion purposes.”

For additional information on the subject, including information pertaining to the use Additional coverage of the issue can be found at the Wall Street Journal (9/19, A5, Tracy, Burton, Subscription Publication),  Reuters (9/19, Huffstutter), the NBC News (9/19, Fox) website, CNN (9/19, Young), CNBC (9/19, Mangan), The Hill (9/19, Goad), Congressional Quarterly (9/19, Gustin, Subscription Publication),Modern Healthcare (9/19, Johnson, Subscription Publication), Newsday (9/19, Ricks), and TIME (9/19, Park)

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