Ebola's threat to the United States
The deadly Ebola virus that continues to rage throughout West Africa poses
little risk to Americans, U.S. health officials stressed Monday. Ebola only
spreads through physical touch, and it can't be spread by people who aren't
showing symptoms of infection, Stephan Monroe, deputy director of the
National Center for Emerging & Zoonotic Infectious Diseases at the U.S.
Centers for Disease Control and Prevention, explained in a Monday afternoon
Those factors -- and the fact that most flights between West Africa and the
United States require one or more stops in other countries -- make it
unlikely that a sick person could make it all the way to America and spread
the Ebola virus, CDC officials said.
Concern was raised over the weekend when it was reported that an
Ebola-infected man from Liberia flew to Lagos, the capital of Nigeria, only
to die soon after his arrival. Health officials are trying to track down any
contacts the man might have had during his journey.
Still, Monroe believes that "the likelihood of this outbreak spreading
outside of West Africa is very low," although countries in the region will
probably continue to see cases.
The current outbreak is the deadliest ever for Ebola, causing more than 670
deaths and 1,200 infections in Guinea, Liberia and Sierra Leone, according
to the World Health Organization.
However, the death rate from Ebola during the current outbreak is about 60
percent compared to 90 percent from prior outbreaks -- indicating that early
treatment efforts have been effective, Monroe said.
A pair of recent cases have highlighted the ease with which people can hop
an airplane after becoming infected with Ebola or having come in contact
with an Ebola patient.
No one is certain how the Liberian man, Patrick Sawyer, was able to board a
plane and travel to Nigeria. His plane had a layover in the West Africa
nation of Togo, and health officials are now scrambling to trace anyone who
may have been exposed to Sawyer at any of the three international airports
through which he traveled. Sawyer, a 40-year-old employee of the Liberian
finance ministry, recently had a sister die from Ebola. He was vomiting and
had diarrhea aboard at least one of his flights, according to the Associated
U.S. doctors are also keeping an eye on the wife and children of a Texas
doctor who was working in Liberia to help Ebola patients. The family
returned to America last week, days before the Dr. Kent Brantly -- who
stayed behind -- came down with Ebola himself.
Public health workers are also discussing whether to step up monitoring at
airports. "The idea of whether additional border-based controls can be more
effective is actively under discussion by the international community,"
But despite these cases, the odds are extremely low that an Ebola infection
could reach the United States and spread into a full-fledged outbreak, said
Thomas Geisbert, an expert on the deadly virus and a professor of
microbiology and immunology at the Institute for Infectious Diseases at the
University of Texas Medical Branch in Galveston.
Instead, Ebola is spread through body fluids like blood, vomit or saliva. A
person has to come into contact with those fluids to risk infection. (HealthDay)
Visit NIH for the release.
airline halts flights to Ebola stricken capitals
Asky Airlines suspended flights to the capitals of Sierra Leone and Liberia,
making it the second carrier in West Africa to halt routes to the cities
after a man with the deadly disease traveled by plane to Nigeria.
Flights to Monrovia and Freetown have been temporarily suspended, the Lome,
Togo-based airline said in a statement handed to reporters. Nigeriaâ€™s Arik
Air canceled its route to those cities yesterday.
A Liberian man died in Lagos, Nigeriaâ€™s commercial capital, last week after
contracting the virus in Freetown. He boarded an Asky flight headed to Lagos
that made a stopover in Lome, according to Nigerian officials.
Visit Bloomberg for the story.
Security disability fund headed in different directions
Medicare's hospital-insurance program spent less on benefits in 2013 than it
did the previous year, despite covering an additional 1 million people,
according to a federal report released Monday, the latest sign that growth
in health costs is tapering off.
The findings come in the annual report card from the trustees of Medicare
and Social Security. They project Medicare will be able to continue paying
full hospital benefits for its elderly or disabled clients without any
changes in the law through 2030â€”four years later than last year's estimate.
Lower-than-expected hospitalization and readmission rates helped curb the
But the Social Security disability-insurance program faces a more pressing
conundrum. The report projects it will be able to pay only 81% of benefits
starting in late 2016 unless Congress intervenes.
Roughly 11 million Americans collected a total of $140 billion in Social
Security disability benefits last year, up from 7.9 million people
collecting $78.2 billion in 2004.
Treasury Secretary Jacob Lew on Monday for the first time endorsed a policy
change that would allocate more payroll-tax revenue to disability benefits,
diverting money from Social Security's main program, which gives monthly
benefits to retirees. If Congress makes the change, the combined funds would
exhaust their reserves by 2033. Without the change, Social Security retiree
reserves would run out in 2034.
The slowdown in Medicare spending over the past few yearsâ€”mirroring slower
growth in health costs reported by private insurersâ€”has stumped economists,
lawmakers and hospital administrators. Many believe it stems from the recent
economic downturn, but the lower spending growth has persisted throughout
Sylvia Mathews Burwell, secretary of the Department of Health and Human
Services, said Medicare's rapid improvement since the 2010 passage of the
Affordable Care Act suggests a direct link to the health law. Her agency
cited provisions of the law that give hospitals incentives to avoid
readmitting patients, saying that led to 150,000 fewer readmissions in 2012
Medicare's hospital-insurance program paid out $261.9 billion on benefits
and consumed $4.3 billion in administrative expenses in 2013. It collected
$251.1 billion in revenue, meaning it had to draw down its trust fund by
$15.1 billion to cover the difference. This gap isn't as wide as previously
forecast, and the trustees believe this trend will continue for several
Per capita Medicare spending, on an average annualized rate, has risen just
0.8% a year in the past four years, reflecting the relative good health of
many aging baby boomers who recently qualified for benefits, compared with
many older, less healthy Americans who pass away. The trustees also noted
that spending on skilled-nursing facilities and home-health care was lower
Eventually, they warned, the aging U.S. population, combined with healthcare
costs that are expected to eventually grow much faster, will wipe out the
trust fund in 2030, if Congress doesn't intervene. If the fund is depleted,
the agency that runs Medicare would be forced to cut benefits.
Visit the Wall Street Journal for the article.
declares medical doctors not the only providers qualified to lead
patient-centered medical homes
The Foundation for Chiropractic Progress (F4CP), a not-for-profit
organization dedicated to raising awareness about the value of chiropractic
care, applauds the Joint Commission, for its restatement in favor of
â€śnon-physicianâ€ť led patient-centered medical home (PCMH) healthcare teams.
The F4CP points to doctors of chiropractic (D.C.s) as being trained to both
serve and lead within the PCMH setting.
â€śCollaboration between providers is a central element to achieving the high
quality and cost-effective goals of the PCMH model,â€ť says Gerard Clum, D.C.,
spokesperson, F4CP. â€śPossessing extensive training in diagnosis and
treatment, doctors of chiropractic (D.C.) can contribute tremendous value to
PCMHs. Particularly, for patients with conditions, such as low back pain,
neck pain and headaches, evidence supports chiropractic as a suitable option
that presents greater opportunity for superior outcomes.â€ť
According to the F4CP report, â€śThe Role of Chiropractic Care in the
Patient-Centered Medical Home,â€ť there are several roles a D.C. can assume
within a PCMH to advance patient care:
As neuromuscular and musculoskeletal specialists with direct patient access
As neuromuscular and musculoskeletal specialists, on referral from primary
care providers (PCP)
As PCPs who also deliver care to patients seeking help for
As providers of diagnostic and therapeutic prevention and health promotion
services, including, but is not limited to, evidence-based diet and exercise
National entities, including the National Committee for Quality Assurance,
Accreditation Association for Ambulatory Health Care and URAC, agree that an
organization can provide the attributes of a PCMH without physician
leadership â€“ with the exception of the American Medical Association House of
Visit Business Wire for the release.
speed and memory complaints can predict dementia
A study involving nearly 27,000 older adults on five continents found that
nearly 1 in 10 met criteria for pre-dementia based on a simple test that
measures how fast people walk and whether they have cognitive complaints.
People who tested positive for pre-dementia were twice as likely as others
to develop dementia within 12 years. The study, led by scientists at Albert
Einstein College of Medicine of Yeshiva University and Montefiore Medical
Center, was published in Neurology.
The new test diagnoses motoric cognitive risk syndrome (MCR). Testing for
the newly described syndrome relies on measuring gait speed (our manner of
walking) and asking a few simple questions about a patient's cognitive
abilities, both of which take just seconds. The test is not reliant on the
latest medical technology and can be done in a clinical setting, diagnosing
people in the early stages of the dementia process. Early diagnosis is
critical because it allows time to identify and possibly treat the
underlying causes of the disease, which may delay or even prevent the onset
of dementia in some cases.
"In many clinical and community settings, people don't have access to the
sophisticated testsâ€”biomarker assays, cognitive tests or neuroimaging
studiesâ€”used to diagnose people at risk for developing dementia," said Joe
Verghese, M.B.B.S., professor in the Saul R. Korey Department of Neurology
and of medicine at Einstein, chief of geriatrics at Einstein and Montefiore,
and senior author of the Neurology paper. "Our assessment method
could enable many more people to learn if they're at risk for dementia,
since it avoids the need for complex testing and doesn't require that the
test be administered by a neurologist. The potential payoff could be
tremendousâ€”not only for individuals and their families, but also in terms of
healthcare savings for society. All that's needed to assess MCR is a
stopwatch and a few questions, so primary care physicians could easily
incorporate it into examinations of their older patients."
The Neurology paper reported on the prevalence of MCR among 26,802
adults without dementia or disability aged 60 years and older enrolled in 22
studies in 17 countries. A significant number of adultsâ€”9.7 percentâ€”met the
criteria for MCR (i.e., abnormally slow gait and cognitive complaints).
While the syndrome was equally common in men and women, highly educated
people were less likely to test positive for MCR compared with less-educated
individuals. A slow gait, said Dr. Verghese, is a walking speed slower than
about one meter per second, which is about 2.2 miles per hour (m.p.h.). Less
than 0.6 meters per second (or 1.3 m.p.h.) is "clearly abnormal."
Dr. Verghese emphasized that a slow gait alone is not sufficient for a
diagnosis of MCR. "Walking slowly could be due to conditions such as
arthritis or an inner ear problem that affects balance, which would not
increase risk for dementia. To meet the criteria for MCR requires having a
slow gait and cognitive problems. An example would be answering 'yes' to the
question, 'Do you think you have more memory problems than other people?'"
For patients meeting MCR criteria, said Dr. Verghese, the next step is to
look for the causes of their slow gait and cognitive complaints. The search
may reveal underlyingâ€”and controllableâ€”problems.
Visit EurekAlert for the study.
In asthma, it's
not just what you smell, but what you think you smell
New research from the Monell Center reveals that simply believing that an
odor is potentially harmful can increase airway inflammation in asthmatics
for at least 24 hours following exposure. The findings highlight the role
that expectations can play in health-related outcomes.
"Asthmatics often are anxious about scents and fragrances. When we expect
that an odor is harmful, our bodies react as if that odor is indeed
harmful," said study lead author Cristina JaĂ©n, PhD, a Monell physiologist.
"Both patients and care providers need to understand how expectations about
odors can influence symptoms of the disease."
Asthma is a chronic inflammatory disorder of the lungs. According to the
National Institutes of Health, over 25 million Americans have the disease,
which can interfere with quality of life. The airways of asthmatics are
sensitive to 'triggers' that further inflame and constrict the airways,
making it difficult to breathe. There are many different types of triggers,
including pollen, dust, irritating chemicals, and allergens. Strong emotions
and stress also can act to trigger asthma symptoms.
Because asthma has no cure, it is important for individuals with the disease
to understand how to manage their symptoms to help prevent severe asthma
Many health organizations list scents and fragrances as asthma triggers,
leading patients to become anxious when exposed to environmental odors. The
current research was conducted to determine whether odor-triggered asthma
symptoms can be elicited or worsened by associated negative expectations.
In the study, published online ahead of print in the Journal of
Psychosomatic Research, 17 individuals characterized as moderate
asthmatics were exposed to the odor phenylethyl alcohol (PEA) for 15
minutes. Often described as rose-smelling, PEA is regarded as a 'pure'
odorant with no associated physiological irritant qualities.
Eight subjects were told that the odor had potential therapeutic properties,
while nine were told that it potentially could cause mild respiratory
During odor presentation, the subjects rated the odor's sensory properties,
including intensity, irritancy, and annoyance. Measures of lung function and
airway inflammation were collected before and immediately after exposure and
again at two hours and 24 hours post-exposure.
Subjects' beliefs about the odor, specifically whether it was potentially
harmful (asthma-triggering) or therapeutic, influenced both their
psychological and physiological responses to odor exposure.
Individuals who were told that the odor was potentially harmful rated it as
more irritating and annoying as compared to those who thought it might be
In addition, airway inflammation increased immediately following odor
exposure in subjects who believed the odor might be harmful and remained
elevated 24 hours later.
There was no increase of inflammation when the odor was characterized as
therapeutic, even in individuals who described themselves as sensitive to
perfumes and other odors.
The findings suggest that some fragrance effects on asthma symptoms may be
related to the expectation of harm as opposed to chemical properties of the
Looking forward, the researchers want to identify the biological mechanisms
that connect expectations to airway inflammation. They also intend to
explore whether a reverse phenomenon also exists. Pamela Dalton, PhD, a
cognitive psychologist at Monell, asks, "Can we improve health outcomes by
reducing concern or fear in a disease where emotional arousal is
Visit Monell for the study.
therapeutic bacteriaâ€™s ability to prevent obesity
Bacteria that produce a therapeutic compound in the gut inhibit weight gain,
insulin resistance and other adverse effects of a high-fat diet in mice,
Vanderbilt University investigators have discovered.
â€śOf course itâ€™s hard to speculate from mouse to human,â€ť said senior
investigator Sean Davies, Ph.D., assistant professor of Pharmacology. â€śBut
essentially, weâ€™ve prevented most of the negative consequences of obesity in
mice, even though theyâ€™re eating a high-fat diet.â€ť
Regulatory issues must be addressed before moving to human studies, Davies
said, but the findings published in the Journal of Clinical Investigation
suggest that it may be possible to manipulate the bacterial residents of the
gut â€“ the gut microbiota â€” to treat obesity and other chronic diseases.
Davies has a long-standing interest in using probiotic bacteria â€” â€śfriendlyâ€ť
bacteria like those in yogurt â€” to deliver drugs to the gut in a sustained
manner, in order to eliminate the daily drug regimens associated with
In 2007, he received a National Institutes of Health Directorâ€™s New
Innovator Award to develop and test the idea.
â€śThe types of bacteria you have in your gut influence your risk for chronic
diseases,â€ť Davies said. â€śWe wondered if we could manipulate the gut
microbiota in a way that would promote health.â€ť
To start, the team needed a safe bacterial strain that colonizes the human
gut. They selected E. coli Nissle 1917, which has been used as a
probiotic treatment for diarrhea since its discovery nearly 100 years ago.
They genetically modified the E. coli Nissle strain to produce a
lipid compound called NAPE, which is normally synthesized in the small
intestine in response to feeding. NAPE is rapidly converted to NAE, a
compound that reduces both food intake and weight gain. Some evidence
suggests that NAPE production may be reduced in individuals eating a
The investigators added the NAPE-producing bacteria to the drinking water of
mice eating a high-fat diet for eight weeks. Mice that received the modified
bacteria had dramatically lower food intake, body fat, insulin resistance
and fatty liver compared to mice receiving control bacteria.
They found that these protective effects persisted for at least four weeks
after the NAPE-producing bacteria were removed from the drinking water. And
even 12 weeks after the modified bacteria were removed, the treated mice
still had much lower body weight and body fat compared to the control mice.
Active bacteria no longer persisted after about six weeks.
The investigators are currently working on strategies to address regulatory
issues related to containing the bacteria, for example by knocking out genes
required for the bacteria to live outside the treated host.
Visit Vanderbilt for the study.
issues skin cancer warning
Skin cancer is on the rise, according to the American Cancer Society, with
more cases diagnosed annually than breast, prostate, lung and colon cancer
On Tuesday, the United States surgeon general issued a call to action to
prevent the disease, calling it a major public health problem that requires
immediate action. Nearly 5 million people are treated for skin cancer each
"Until today, the surgeon general has never said, 'UV radiation is bad for
you; protect your skin,' " acting Surgeon General Dr. Boris Lushniak said.
The U.S. Department of Health and Human Services has set five goals for
communities to decrease the risk of skin cancer, such as providing shade at
parks, schools and other public spaces, and reducing indoor tanning.
A dermatologist himself, Lushniak said it's important for parents to teach
their children about sun safety, just as they would dental care and eating
"We have to change the social norms about tanning," he said. "Tanned skin is
damaged skin, and we need to shatter the myth that tanned skin is a sign of
Melanoma, the deadliest form of skin cancer because of how fast it spreads
to other parts of the body, accounts for only 2% of skin cancer cases but is
responsible for the majority of skin cancer deaths, according to the
American Cancer Society.
Each year, more than 63,000 cases of melanoma are diagnosed in the United
States, and 9,000 people die from it. From 1973 to 2011, melanoma rates
increased more than 200%, according to the Department of Health and Human
Services. The National Cancer Institute reported that melanoma is the most
common form of cancer in adults ages 25 to 29 and second most common for
young adults aged 15 to 29.
To reduce the risk of skin cancer, the Centers for Disease Control and
Prevention recommends wearing a hat, sunglasses and protective clothing and
using sunscreen with an SPF of at least 15.
On Monday, the House of Representatives passed the Sunscreen Innovation Act.
The bill includes a review process for all manufacturers submitting a new
sunscreen to the Food and Drug Administration, with a deadline for the FDA
to provide final decisions: one year for pending applications and 1Â˝ years
for new ones.
The last over-the-counter sunscreen ingredient approved by the FDA was in
the 1990s, according to the Public Access to SunScreens Coalition. Eight new
sunscreen applications have since been filed with the FDA. All are still
waiting for review, the coalition says; some have been waiting for over a
The current policy requires the FDA to undergo an extensive rule-making
process before reviewing any new product application and adding it to the
approved list, according to coalition policy director Michael Werner. This
can take years, making the process inefficient.
Many of the new sunscreens awaiting approval in the United States have been
available in Europe, Central Asia and South America for years. Generally
speaking, the ingredients waiting for approval are simply newer types of UVA
filters than are currently being used, Werner said, but they differ slightly
Visit CNN for the announcement.