2013:  H7N9
"About Town" Interview Part 1 - WATCH IT NOW
Introduction to the Westport Weston Health District
"About Town" Interview Part 2 - WATCH IT NOW
All about H1N1!
"About Town" Interview Part 3 - WATCH IT NOW
WWHD Environmental Health Services

Go direct to our section on swine flu here

D I S E A S E S  :   in some cases, cause and effect.   Westport-Weston Health District here.  CT TO THE FORE IN GENETIC TESTING?



UNH prof closes in on Lyme disease breakthrough
New Haven Register
By Susan Misur, Register Staff, smisur@nhregister.com / Twitter: @nhrsusan
Thursday, October 25, 2012

WEST HAVEN — A University of New Haven professor is on her way to determining why Lyme disease may be resistant to treatment, citing her diagnosis with the ailment eight years ago as motivation.

Research by Eva Sapi, an associate professor of biology and environmental science at the school, was published Wednesday and says bacteria causing Lyme disease can form a protective layer called biofilm over itself. That special coating may prevent antibiotics from attacking it.

“Why is this important? For other bacteria, biofilms are shown to be very resistant to antibiotics, temperature, anything you can throw at it, it’s protected from it. The bacteria protects itself from a harsh environment,” said Sapi, who is originally from Hungary and also studied at Yale.

Online publication PLOS-ONE, a peer-reviewed, international science journal that stands for the Public Library of Science ONE, printed the study, of which Sapi is the principal author.

Sapi learned she had Lyme disease, a tick-borne illness, about eight years ago after she began feeling ill and had started a job at UNH. Doctors performed tests for several months before they determined Lyme disease caused her symptoms.

“I became very ill to point that I couldn’t even walk … I was in the dark, and I didn’t know what to do, and in the meantime, I didn’t feel good,” Sapi said. “The whole experience really prompted me to look into this disease.”

Lyme disease, which was first found in Connecticut in 1975, costs the country around $1 billion annually, when considering how many doctors and tests it can take to be diagnosed, legal fees connected to incorrect diagnoses, and more, according to Sapi.

She wanted to find out why treatments often aren’t effective and what other diseases or parasites people and animals could contract from ticks. Over the years, while working with a team of UNH graduate students and Michael Rossi, co-chair of the UNH Department of Biology, Sapi found that Borrelia burgdorferi, the causative agent of Lyme disease, is more resistant to treatment when it’s in certain forms and covered in a protective biofilm. Once treatment ends, the bacteria remains and can become more active.

The next step is proving biofilm is in ticks and tissues of infected humans or animals and if it helps protect the bacteria against treatment, such as antibiotics, Sapi said.

Rossi said he got involved about three years ago because he specialized in a testing technique Sapi wanted to use in her work and will continue assisting in the research.

“It is a hypothesis that’s worth pursuing, and she’s doing an excellent job,” Rossi said.

Sapi secured grants from multiple organizations that address Lyme disease, including Stamford’s Lyme Research Alliance. According to Executive Director Peter Wild, the Lyme Research Alliance will provide more funding for Sapi’s studies.

“We wanted to know more about the organisms that outlast the antibiotic onslaught, and Eva was proposing to do that, and I’m delighted to say she’s found at least one mechanism by which Borrelia survives … and that is biofilm,” Wild said. “Once you understand what the mechanism is, then you’re looking for ways to disrupt that mechanism. ... Researchers can then develop some targets for therapies.”

Call Susan Misur at 203-789-5742.

In Portland, fluoride debate is ideological clash
YAHOO
By STEVEN DUBOIS | Associated Press
11 Sept. 2012

PORTLAND, Ore. (AP) — It's a dental story told so often it borders on cliche.

When someone moves to Portland from another state — and that's most people you meet in this city of transplants — their new dentist takes one look at their excellent teeth and concludes they must have been raised elsewhere, a place that puts fluoride in its drinking water.

The tale is also told from the perspective of native Portlanders.

"I have had several dentists comment on my and my children's teeth, saying: 'Oh, I can see you grew up in Portland,'" Mary Lou Hennrich said. And that's no compliment, she added.

Portland is the largest city in the U.S. that has yet to approve fluoridation to combat tooth decay, a distinction that could change at Wednesday's city council meeting. Mayor Sam Adams and two city commissioners have announced their support, ensuring a majority on the five-member panel.

Fluoridation has been an emotional topic in communities across the country for more than 50 years, and continues to be in cities ranging from conservative Wichita, Kan., to a place whose unofficial motto is "Keep Portland Weird."

Portland is considered one of the nation's most liberal, and the issue presents a clash between two progressive positions: the desire to improve the dental health of low-income children and the impulse to avoid putting anything unnecessary in the air, food or water.

"The fact that Portland stands out as the largest U.S. city without fluoridation is not the kind of weird we should be," the mayor said. "This is causing pain to kids."

Many in Portland and the state have long opposed public fluoridation, saying it's unsafe and violates an individual's right to consent to medication. While 73 percent of the U.S. population drinks water treated with fluoride, the rate is less than 25 percent in Oregon.  Portland voters twice rejected fluoride before approving it in 1978. They overturned their decision before it was ever added to the water.

The issue re-emerged last month, when a coalition of health and other organizations that had been lobbying the council for more than a year gained the public support of Commissioner Randy Leonard.  Opponents criticized the council for rushing into action without a public vote, and plan to collect signatures to force a referendum on it in May 2014. More than 225 people signed up to testify at a public hearing last week that ran 6 ½ hours. Sixty-one percent opposed fluoridation.

"Barnyard animals are force medicated, not human beings," said Mike Smith, a member of the Occupy Portland movement.

Portland's drinking water already contains naturally occurring fluoride, though not at levels considered to be effective at fighting cavities.  A 2007 report from the state Department of Human Services said 35 percent of Oregon first-through-third graders had untreated dental decay, a higher percentage than in neighboring states with more fluoridation, such as Washington (19 percent) and Idaho (27 percent). Dentists describe a health care crisis, with their offices and clinics inundated with cavity-ravaged youngsters.

"A lot of these kids will have such severe problems that they need to be hospitalized in order to have their dental care done," said Lisa Bozzetti, dental director at the Virginia Garcia Memorial Health Clinic.

Fluoride opponents, however, say the dental benefits of the mineral are small (better diets would have greater impact) and don't outweigh the negatives.

The Internet is rife with warnings about fluoridation, and residents with thyroid issues, kidney disease and multiple chemical sensitivity worry it will make their lives worse. Others say it reduces IQ and can cause autism, memory loss, attention deficit hyperactivity disorder and other problems.  Rick North, the former executive vice president of the American Cancer Society in Oregon, said he figured fluoride was OK until he started researching the issue several years ago and spotted many red flags. Supporters, he said, believe it is a "silver bullet" to fight cavities and won't hurt anyone else.

"But you can't put a drug into the water supply and expect that it's not going to have side effects," he said.

Commissioner Nick Fish, who co-sponsored the plan, said more than 200 million Americans drink water with added fluoride, and it doesn't appear to have caused great harm. Most mainstream health organizations, such as the American Medical Association and American Dental Association, endorse it as safe.

"Over the last 50 years, as we have fluoridated more water, the overall IQ of Americans has gone up," he said. "I don't suggest a cause-and-effect, but I also think it shows the reverse isn't true."

The ordinance to be voted on Wednesday calls for the water to be fluoridated by March 2014 at a projected upfront cost of $5 million.   Mayor Adams, who is not seeking re-election, said he planned to take time before the vote to research how people with the health conditions described at the public hearing live in cities that fluoridate. But he has yet to hear anything persuasive enough to change his opinion that it is a safe and effective way to help children born into families that can't afford dentists or don't stress dental health.

"Science is about the preponderance of evidence," he said. "There are very few proofs in this world."


FROM WIKIPEDIA (r)
The Four Horsemen of the Apocalypse are described in the last book of the New Testament of the Bible, called the Book of Revelations. Opening the seven seals, summoned forth are four beings that ride out on white, red, black, and pale horses. The four riders in the Durer above right symbolize Pertilence, War, Famine and Death, respectively.

Amid Japan crisis, hunt for better radiation care
YAHOO
By LAURAN NEERGAARD, AP Medical Writer
Tue Mar 29, 3:09 am ET

WASHINGTON – Japan's nuclear emergency highlights a big medical gap: Few treatments exist to help people exposed to large amounts of radiation.

But some possibilities are in the pipeline — development of drugs to treat radiation poisoning, and the first rapid tests to tell who in a panicked crowd would really need them.

The U.S. calls these potential products "countermeasures," and they're part of the nation's preparations against a terrorist attack, such as a dirty bomb. But if they work, they could be useful in any kind of radiation emergency.

"Thinking of terrorist events is what drives us. Mother Nature can be much of a terror, too," says Dr. Robin Robinson, who heads the federal Biomedical Advanced Research and Development Authority, or BARDA, that funds late-stage research of products the government deems most likely to pan out.

BARDA has invested $164 million for research into anti-radiation treatment candidates since 2008, and $44 million for radiation testing — in hopes of adding such products to the nation's emergency medical stockpile soon. That's in addition to research dollars from the National Institutes of Health and the Defense Department.

Japan's crisis — where last week two nuclear plant workers were hospitalized for radiation burns — is sure to renew attention to a field that's long been overshadowed by the hunt for protections against bioterrorism, not radiological emergencies. Among the radiation projects considered farthest along in development:

_Rapid tests that could spot dangerous radiation doses with mere finger-pricks of blood. Already, a prototype machine sits at New York's Columbia University that could check thousands of people.

_Some drugs now used to help cancer patients boost their infection-fighting blood cells, sold under such names as Neupogen. They may do the same thing for radiation victims.

_An injection that saved monkeys from highly lethal beams. It seems to protect the body's two most radiation-sensitive spots, the bone marrow and lining of the gut.

Today, there are only a few proven therapies for radiation injuries. Good supportive care — lots of fluids, infusions of blood-clotting platelets, and infection-fighting antibiotics — is key for acute radiation syndrome, an overall poisoning that can begin causing symptoms days to weeks after a super-high exposure. To guard against longer-term harm, doses of potassium iodide can protect against future thyroid cancer by shielding the thyroid from one type of fallout, radioactive iodine. A few other treatments can help the body eliminate radioactive cesium and a few other isotopes.

Part of the challenge is radiation's variety of injuries — burns, bone marrow and gastrointestinal damage, lung scarring, the later-in-life cancer risk. Yet outside of an immediate blast zone where open wounds and burns make injury clear, there's no fast way to tell who got a huge dose.

Those Geiger counter-style monitors used on power-plant workers in Japan? They detect contamination on clothing or skin that might not enter the body, not what the body has absorbed, says medical physicist David Brenner, director of Columbia's Center for Radiological Research.

Moreover, previous emergencies have shown that sheer stress can cause nausea and diarrhea that mimic some early symptoms of radiation sickness in people who weren't exposed, he adds.

"Before you can start to treat people, you need to know what radiation doses they got," Brenner says. "If you take a guess and get it wrong, you might do more harm than good."

So his team developed a way to detect early, DNA-based signs of radiation damage that estimated dose — using a drop of blood like diabetics use to test their blood sugar.

Brenner's team built a robotic machine named RABiT -- for "rapid automated biodosimetry tool" — that can analyze those bloodspots quickly. The eventual goal is to be able to test 30,000 blood samples in a day. Brenner is working with Northrop Grumman to make the machinery smaller, even portable.

Brenner says federal approval is still a few years away but that the prototype could be used in an emergency if health officials shipped blood samples to his lab.

What about treatments?

Cells in the bone marrow and GI tract are extremely vulnerable to radiation. They overreact to what should be reparable damage and commit cellular suicide, says Dr. Andrei Gudkov of the Roswell Park Cancer Institute.

Gudkov's team created a drug based on a protein from normal gut bacteria, named flagellin, that blocks some of the cellular destruction and also stimulates recovery of remaining cells. It dramatically improved the survival of monkeys treated up to 48 hours after they were zapped. And safety testing in 150 healthy people so far suggests the main side effect is a flulike reaction, Gudkov says. Cleveland BioLabs Inc. is doing further work needed for Food and Drug Administration evaluation.

BARDA's Robinson says that closest to the emergency stockpile may be those cancer drugs that spur growth of infection-fighting blood cells. Later this year, his agency will begin a push for research to prove they could work similarly in a radiation emergency.

"There isn't going to be a simple solution to any of this," cautions Dr. Nelson Chao of Duke University's countermeasures program, who also co-chairs the Radiation Injury Treatment Network. "There will be a lot of little steps to address the plethora of toxicities that come from radiation."

Radiation From Stricken Japanese Plant Reaches Mass., Other States
No Iodine-131 Detected In Connecticut So Far
The Hartford Courant
By DAVID OWENS, dowens@courant.com
8:07 PM EDT, March 28, 2011


Radiation believed to be from the Fukushima nuclear power plant, crippled March 11 when an earthquake and tsunami struck northern Japan, has reached the United States and been detected near Boston, but so far no increased levels of radiation have been detected in Connecticut.

Iodine-131, a byproduct of nuclear energy production, was detected in a sample collected March 22 from a rainwater monitoring station in Boston, according to the Massachusetts Department of Public Health.

Gov. Dannel P. Malloy said Monday that rainwater was being tested in Connecticut and that radiation levels remained in the range of what is normally seen.

"Our routine testing shows no concern for public health," Malloy said in a statement released by his office. "Even in other states where trace amounts of radiation have been detected, it's not at levels high enough to impact health and welfare. We will continue to be aware and alert while monitoring the situation."

The radioactive material that fell in Massachusetts and that was detected elsewhere in the country was carried by clouds, and that is going to continue until the crisis in Japan is resolved.

The U.S. Environmental Protection Agency said that the levels being detected in the U.S. "are to be expected in the coming days and are still far below levels of public health concern."

The EPA has taken steps to increase nationwide monitoring of precipitation, drinking water, air and milk.

After the increased level of I-131 was detected in Boston last week, Massachusetts officials checked the Quabbin and Wachusett reservoirs and no I-131 was detected. Officials said they'd expect to find much lower concentrations, if any, in drinking water sources because rainwater would be greatly diluted.

At least 15 states have reported detecting radioactive isotopes in air or water or both, but no states have recommended that residents begin taking potassium iodide, a salt that protects the thyroid from radioactive iodine.

The EPA is using its nationwide monitoring system called RadNet to monitor radiation from the Japanese plant. It was a RadNet monitor in Boston that detected the I-131.

The Nuclear Regulatory Commission has said that it does not expect harmful levels of radiation to reach the U.S.

Radiation at the Fukushima plant poses a threat to workers, but Japanese officials and international experts have said that radiation levels away from the plant are not dangerous to people.

Officials: Big spike at Japan nuke plant an error
YAHOO
By YURI KAGEYAMA and MARI YAMAGUCHI, Associated Press
27 March 2011

TOKYO – Emergency workers struggling to pump contaminated water from Japan's stricken nuclear complex fled from one of the troubled reactors Sunday after reporting a huge increase in radioactivity — a spike that officials later apologetically said was inaccurate.

The apology came after employees fled the complex's Unit 2 reactor when a reading showed radiation levels had reached 10 million times higher than normal in the reactor's cooling system. Officials said they were so high that the worker taking the measurements had withdrawn before taking a second reading.

On Sunday night, though, plant operators said that while the water was contaminated with radiation, the extremely high reading was a mistake.

"The number is not credible," said Tokyo Electric Power Co. spokesman Takashi Kurita. "We are very sorry."

He said officials were taking another sample to get accurate levels, but did not know when the results would be announced.

The situation came as officials acknowledged there was radioactive water in all four of the Fukushima Dai-ichi complex's most troubled reactors, and as airborne radiation in Unit 2 measured 1,000 millisieverts per hour — four times the limit deemed safe by the government, Kurita said.

Officials say they still don't know where the radioactive water is coming from, though government spokesman Yukio Edano has said some is "almost certainly" seeping from a cracked reactor core in one of the units.

While the discovery of the high radiation levels — and the evacuation of workers from one reactor unit — again delayed efforts to bring the deeply troubled complex under control, Edano insisted the situation had partially stabilized.

"We have somewhat prevented the situation from turning worse," he told reporters Sunday evening. "But the prospects are not improving in a straight line and we've expected twists and turns. The contaminated water is one of them and we'll continue to repair the damage."

The discovery over the last three days of radioactive water has been a major setback in the mission to get the plant's crucial cooling systems operating more than two weeks after a massive earthquake and tsunami.

The magnitude-9 quake off Japan's northeast coast on March 11 triggered a tsunami that barreled onshore and disabled the Fukushima plant, complicating an immense humanitarian disaster.

The death toll from the twin disasters stood at 10,668 Sunday, with more than 16,574 people missing, police said. Hundreds of thousands of people are homeless.

Workers have been scrambling to remove the radioactive water from the four units and find a safe place to store it, TEPCO officials said.

On Sunday night, Minoru Ogoda of Japan's nuclear safety agency said each unit could have hundreds of tons of radioactive water.

The protracted nuclear crisis has spurred concerns about the safety of food and water in Japan, which is a prime source of seafood for some countries. Radiation has been found in food, seawater and even tap water supplies in Tokyo.

Just outside the coastal Fukushima nuclear plant, radioactivity in seawater tested about 1,250 times higher than normal last week — but that number had climbed to 1,850 times normal by the weekend.

Hidehiko Nishiyama, a nuclear safety official, said the increase was a concern, but also said the area is not a source of seafood and that the contamination posed no immediate threat to human health.

Experts with the International Atomic Energy Agency said the ocean would quickly dilute the worst contamination.

Up to 600 people are working inside the plant in shifts. Nuclear safety officials say workers' time inside the crippled units is closely monitored to minimize their exposure to radioactivity, but two workers were hospitalized Thursday when they suffered burns after stepping into contaminated water. They are to be released from the hospital Monday.

Edano has urged TEPCO to be more transparent about the potential dangers after the safety agency revealed the plant operator was aware of high radiation levels in the air in Unit 3 several days before the two workers suffered burns there.

A top TEPCO official acknowledged Sunday it could take a long time to completely clean up the complex.

"We cannot say at this time how many months or years it will take," TEPCO Vice President Sakae Muto said, insisting the main goal now is to cool the reactors.

A poll, meanwhile, showed that support for Japan's prime minister has risen as the administration tackles the disasters.

The public opinion poll conducted over the weekend by Kyodo News agency found that approval of Prime Minister Naoto Kan and his Cabinet rose to 28.3 percent after sinking below 20 percent in February, before the earthquake and tsunami.

Last month's low approval led to speculation that Kan's days were numbered. While the latest figure is still low, it suggests he is making some gains with voters.

About 58 percent of respondents in the nationwide telephone survey of 1,011 people said they approved of the government's handling of the March 11 earthquake and tsunami, but a similar number criticized its handling of the nuclear crisis.
Fukushima workers in hospital after radiation exposure
24 March 2011 Last updated at 05:20 ET

Two workers at Japan's damaged Fukushima Daiichi nuclear power plant have been taken to hospital after being exposed to high levels of radiation.  The pair had been attempting to restore the cooling system in reactor 3, which was damaged by the quake on 11 March.  Several workers have now been hurt on the site, an indication of the scale of the task facing them.

Radiation levels in Tokyo's water supply have now fallen, but remain high in other areas of northern Japan.  The official death toll from the magnitude 9.0 quake and subsequent tsunami has now risen to 9,523. Another 16,094 people are listed as missing.  Japan's nuclear safety agency said three workers had been injured when their feet came into contact with radiation-contaminated water while laying cables in the turbine area of reactor 3.

They were exposed to radiation levels of 170-180 millisieverts, he said, which is lower than the maximum level permitted for workers on the site of 250 millisieverts. Two of the workers were taken to hospital.

"Although they wore protective clothing, the contaminated water seeped in and their legs were exposed to radiation," said a spokesman.

"Direct exposure to radiation usually leads to inflammation and so that's why they were sent to the hospital to be treated."

Most people are exposed to 2 millisieverts over the average year, while 100 millisieverts is considered the lowest level at which any increase in cancer is clearly evident.  The condition of the injured workers was not immediately known.  Japan's chief cabinet secretary Yukio Edano said the situation was "very regrettable".'Serious concern'

The power plant's cooling systems failed after the quake and tsunami, leading to the reactors overheating.  Power has now been restored to the site, but work to restart the coolers in reactor 3 was briefly suspended on Wednesday after a plume of black smoke was seen coming from it.  Tokyo Electric Power Co, which operates the plant, later allowed workers to re-enter after establishing there was no fire and that radiation level in the area had not risen.

The International Atomic Energy Agency (IAEA) said there had been some "positive developments" at the site but that the situation was still "of serious concern".

The plant is 250km (155 miles) north-east of the capital, Tokyo. The government has declared a 20km exclusion zone and evacuated tens of thousands of people. Those living up to 30km away have been told to stay indoors to minimise exposure.  People in Fukushima prefecture have been told not to eat 11 types of green leafy vegetables grown locally because of contamination worries. Local producers have been ordered not to send the goods to market.

Tokyo residents were warned on Wednesday not to give tap water to babies less than a year old because levels of radioactive iodine - which can cause thyroid cancer - are twice the recommended safe level in some areas of the city.  Officials stressed that children would have to drink a lot of it before it harmed them and urged people not to panic-buy. But supermarket shelves were reported to have been cleared of bottled water by Thursday morning.

"Customers ask us for water. But there's nothing we can do," Masayoshi Kasahara, a supermarket worker in Tokyo told Reuters.

"We are asking for more deliveries but we don't know when the next shipment will come."

Emergency shelters

Radiation readings on Thursday showed levels in water in Tokyo had fallen back below the danger level, but the municipal authorities are distributing thousands of bottles of water to households with infants.

The authorities in the nearby city of Kawaguchi, Saitama prefecture, also reported radiation levels above safety norms in its water supply on Thursday.  Concern is also growing among Japan's neighbours. Australia has become the latest country to ban food imports from the affected region.  Police believe the final death toll from Japan's twin disaster may be more than 18,000.

Most of the deaths - 5,700 - have been reported in the prefecture of Miyagi. Three thousand bodies have been found in Iwate prefecture, and 776 in Fukushima.

At least 18,000 houses were destroyed and 130,000 damaged, and more than 200,000 people are living in emergency shelters.  The Japanese government has said it will cost as much as 25 trillion yen ($309bn; £189bn) to rebuild the country after the disaster.



A field can be more than one thing; "turf" can have more than one meaning, too!  Link to history of artificial fields project in Weston here.

Study Says Sports Fields Made Of Ground-Up Rubber Pose No Hazard
Hartford Courant
By JULIE STAGIS, jstagis@courant.com
9:28 PM EDT, July 30, 2010

HARTFORD — Outdoorsports fields made with ground-up rubber pose no special environmental hazards to athletes, a study released Friday shows.

So-called crumb rubber infill, mostly composed of recycled tires, has been the subject of hot debate in recent years. Several studies in Europe and a few in North America have shown that rubber "crumbs" used in some artificial turf release toxins that might cause health problems and be poisonous to plants.

But the findings of the new study, funded with $245,000 available to the Department of Environmental Protection for special projects to settle cases where environmental regulations have been violated, say the levels of chemical emissions are not harmful.

The UConn Health Center, Connecticut Agricultural Experiment Station, the Department of Public Health and the DEP studied the health and environmental impacts of crumb rubber.

In July 2009, researchers from the UConn Health Center studied the chemical emissions at four outdoor turf fields and one indoor turf field. The outdoor conditions were warm, sunny and low-wind, according to the health department report.

At each field, three soccer players wore personal monitoring devices, according to a press release from the DEP. The recorded results from the monitoring devices were evaluated with stationary samples from the artificial turf to distinguish chemical exposures.

Using that data, the health department concluded that the chemical exposures were not elevated compared with what people are exposed to in typical outdoor air, the release states. Emissions for indoor fields were higher, however, and the health department said that while the levels did not pose a health risk, indoor fields should be ventilated.

They also suggested that developers consider alternatives to crumb rubber when planning indoor fields in the future.

Environment and Human Health Inc., a North Haven-based nonprofit organization whose board comprises 10 doctors and public officials, paid for the Connecticut Academy of Science and Engineering — a private, nonprofit, public service institution — to conduct a study on crumb rubber in 2007. The study tested outgassing and leaching from synthetic turf rubber crumbs and positively identified four chemicals that can cause skin and eye irritation, cancer and can corrode and destroy mucous membranes.

Environment and Human Health also pushed for the state to appropriate $250,000 for the DEP to study turf toxicity.

"We cannot comment on the validity of the study until we see the data," Nancy Alderman, president of Environment and Human Health, said in an e-mail. "Nothing in this press release changes EHHI's concern for children playing on ground-up rubber tires."

Concerns about zinc levels in water runoff from artificial turf fields have also been raised in recent years. The DEP assessed eight samples of storm water runoff. Three had elevated zinc levels, according to the press release.

The DEP said the zinc levels do not pose a risk for drinking water but may be harmful to aquatic organisms in surface waters. It suggested that owners of artificial turf fields treat storm water to reduce zinc concentrations and eliminate harm to aquatic organisms.

Other metals and rubber-related compounds were not evaluated, the study says.

Officials from parks and recreation departments and school districts that have touted the benefits of artificial turf fields say the turf doesn't require pesticides, needs less maintenance, causes fewer injuries, doesn't fall victim to bad weather, and makes it possible for multiple sports to be played on the field during the same season without wearing it out.

High lead concentrations in AstroTurf, which uses a different synthetic surface than newer artificial turf fields, caused an uproar in 2008 when several AstroTurf fields were closed. The new study did not find high lead concentrations in crumb rubber, the health department report states.
Health advisory posted at Ridgefield artificial turf fields; other towns differ in approach
CTPOST
By Robert Miller, STAFF WRITER
Updated: 06/08/2009 11:28:05 PM EDT

RIDGEFIELD -- The two artificial turf fields in town now come with warning labels.

The town's Health Department has posted signs at fields at Ridgefield High School and the Scotts Ridge Middle School warning students and parents to follow some simple rules after playing on artificial turf.  These include washing hands thoroughly and watching the temperature on hot days, when the artificial turf, filled in with black rubber crumbs, can absorb and release heat, jacking up the temperature on playing fields.

Ridgefield is the second town in the state, with Westport, to post such signs.  Ed Briggs, Ridgefield's health director, said Monday his department posted the warnings after consultation with the Board of Selectmen.

For opponents of artificial turf, the signs are important reminders that the fields may have health hazards.  They claim the filler used to cushion the fields, crumb rubber made from chewed-up tires, can release toxic chemicals. One mode of release, they say, is gas that escapes when the sun heats the rubber. Another is the dust created when players grind the rubber to dust.

"We need more public conversation about this," Elizabeth Butler, one of the activists who have opposed construction of a new artificial turf field in Ridgefield, said Monday. "This is a public safety issue."

The opposition argument carried the day in February 2008, when the town decisively rejected plans to build an artificial turf field at the Onalfo Sport Complex.  In Danbury, artificial fields are at Danbury High School and Broadview Middle School, and the city is installing another at Rogers Park.  Mayor Mark Boughton said Monday that city officials, having reviewed studies on artificial turf, concluded the fields are safe for children to use, so he does not think the city will post signs like those in Ridgefield. But Danbury may give some of the same recommendations to groups seeking the city's permission to use its fields.

New Fairfield First Selectman John Hodge said the two artificial turf fields at New Fairfield High School are in constant use, and the town hasn't received any complaints about them.  The town has not considered posting safety warnings at the fields, in part because it has already instructed coaches and parents about cleaning and dressing any scrape or cut kids incur on the fields to prevent infection.  He also said that in summer, when the fields can heat up, teams make sure they have plenty of water and sports drinks on hand.

Newtown has two artificial fields at Treadwell Park. The town's Parks and Recreation director, Amy Mangold, said she and others have studied all the available information on the safety of artificial turf and concluded there are no health concerns that warrant action, including warning signs.

The debate is moving to the national stage. One official with the U.S. Environmental Protection Agency in January urged the EPA back away from endorsing artificial turf fields until the agency gathers more information.  The state Department of Environmental Protection is beginning a $245,000 study of artificial turf.

The controversy over the artificial playing field at Brookfield High School has had more to do with its faulty installation and repair than about safety.

First Selectman Robert Silvaggi said Monday no residents have raised health issues and the town does not plan to post signs. "We've read the reports raising concerns. We've also read the reports saying the fields are safe."

Ridgefield's First Selectman Rudy Marconi said one reason that results of different tests of artificial fields is that the rubber used in them isn't uniform. Some crumb rubber may have higher levels of toxins, some lower levels, because different tires have different levels of the chemicals.
Artificial turf ban passes legislative vote
Stamford ADVOCATE
By Brian Lockhart, Staff Writer
Posted: 03/18/2009 08:57:01 PM EDT
Updated: 03/19/2009 07:19:26 AM EDT

HARTFORD -- Rep. Kim Fawcett, D-Fairfield, rushed around the capitol Wednesday urging colleagues on the environment committee to support her bill placing a temporary moratorium on construction of state-funded artificial turf athletic fields.

The committee passed the legislation, in a 21-to-11 vote.

Fawcett afterward acknowledged the proposal, which now heads to the public health committee, is a mostly symbolic statement of lawmakers' concerns the crumbled tires that cushion the fields are harmful to human health and the environment.

The moratorium, which would last until Feb. 1, 2010, when the state concludes a study of the fields, is limited to state-funded projects. It grandfathers two fields being built for the state university system.

A controversial provision requiring warning signs be erected at artificial turf fields was stripped from the bill.

But Fawcett hopes the legislation, if passed by the full General Assembly and signed into law by the governor, will be a warning to municipalities considering installing the fields.

Other lower Fairfield County lawmakers on the environmental committee were torn over Fawcett's proposal.

Rep. Fred Camillo, R-Greenwich, said he has reviewed existing information on the fields and nothing has convinced him they pose a health threat.

"I usually vote on the safe side of things, but I don't see any evidence this causes illness," Camillo said, adding that proponents' willingness to allow the existing state projects to move ahead undercuts their campaign to halt installations.

"That defeats the whole argument they're dangerous," Camillo said. "If they were convinced it was definitely bad they wouldn't want it in any instance."
Conn. firm says artificial turf no health threat 
DAY
Posted on Jan 28, 6:58 AM EST

CHESHIRE, Conn. (AP) -- A Connecticut firm has concluded that artificial turf made from crushed rubber does not pose any health risks, but an environmental group is questioning the methodology and the firm's objectivity.

Concerns have been raised across the country about the safety of artificial turf made from crushed tires because of the industrial chemicals it contains.

Cheshire-based Milone & MacBroom Inc., an engineering, environmental and landscape architecture firm, studied synthetic turf so it could inform clients about any safety issues, said Vincent McDermott, a senior vice president at the firm.

Milone & MacBroom's clients have included Yale University and other schools that have installed artificial turf fields, as well as schools that have opted for natural grass fields. The firm release the study's findings last month, and it found no health risks.

"At this point, based on the data we have before us, we are not going to say to stop using this product because of health problems," McDermott said. "What we published is really totally unbiased, in my opinion."

Nancy Alderman of North Haven-based Environment and Human Health Inc., is questioning Milone & MacBroom's conclusions and the firm's objectivity. The nonprofit group, which includes doctors, has concerns about artificial turf's effect on children's health and says more studies are needed.

"I think it's important to know that they are installers of those fields," she told the New Haven Register.

Milone & MacBroom's study focuses on whether synthetic fields become excessively hot in the summer, whether they affect air quality and whether the materials leach from the turf and affect water quality.

The firm found that artificial grass blades reached 156 degrees on a hot summer day, but the air 2 feet above the field was only 1 to 3 degrees above the air temperature. The firm noted that artificial fields aren't usually played on in the middle of summer.

The firm also tested levels of toxic chemicals benzothiazole and 4-tert-octylphenol and found "no detectable concentrations of either compound." It also found only "a very low concentration" of volatile nitrosamines in one location.

Alderman said Milone & MacBroom should have tested several other compounds, and the firm's air samplers took in only 75 liters per hour while people breathe in 1,000 liters per hour.

"The samplers were simply too small," she said.

The firm also found that crushed rubber has the potential to leach metals, but at concentrations under limits established by state environmental regulators.

"From a liability point of view, if I found there was a water problem I'd want to know about it because I'm not about to recommend something I know is bad," McDermott said.

The state Department of Environmental Protection is planning its own study of synthetic turf fields, and state lawmakers are debating a proposal to ban any new artificial fields until that study is done.
Artificial Turf Health Study Ready To Begin 
DAY
By Megan Bard    
Published on 1/5/2009
 
It's been a concern for towns across the country: exactly what potential harm can come from installing and playing on artificial turf made from old tires?

This month, state environmental and health officials will begin a year-long study of the fields, made from crumb rubber fibers, in an effort to definitively answer whether it's safe for athletes and the environment.

On Friday, state Department of Environmental Protection officials announced that they will use $245,000 from a $750,000 settlement reached in May with the developers of the Montville Commons project in Montville to pay for the study.

“This study is being conducted to respond in a credible manner to concerns that many people have raised about the potential impact of the presence of crumb rubber on playing fields,” DEP Commissioner Gina McCarthy said in a prepared statement.

Throughout the state, fields that include the recycled tire material has been installed in more than 80 municipalities. Locally, such fields are used at Connecticut College, the U.S. Coast Guard Academy and Montville High School.

As town budgets get tighter, the artificial turf fields are attractive because they reduce maintenance costs and demand for water and pesticides used to care for natural grass.

The crumb rubber is often used as an infill, which provides a layer of padding that holds the artificial grass blades in place, helping to reduce athletic injuries and improving drainage of the fields.

Because the rubber is primarily composed of recycled tires, which are made of manmade and natural rubber, various chemicals and volatile organic compounds are found in the material, which can also include heavy metals such as zinc and copper, according to the DEP.

Montville Superintendent of Schools David Erwin has said that before the field was installed at Montville High School, state health officials and the installer assured him that the rubber crumbles did not pose a health risk.

However, in 2007, the Connecticut Agriculture Experiment Station completed a study determining that the recycled tire crumbs used to soften the synthetic turf fields can emit four volatile organic compounds which can release gases into the air when heated by the sun, according to state Attorney General Richard Blumenthal. He said the gases could cause short- or long-term health problems.

The study was not conclusive and warranted further review, according to the DEP.

The study set to begin this month will also evaluate older turf fields in which lead paint has been used to keep the green color of the field from fading. Roughly a dozen towns in the state have these fields and are considering replacing them with the more modern, rubber crumble fields. 
DeLauro slams commission, says turf study ‘flawed’
New Haven REGISTER
By Abram Katz, Register Science Editor
8/11/2008
 
U.S. Rep. Rosa L. DeLauro , D-Conn., has fired off a salvo of letters to the U.S. Consumer Protection Agency and the Environmental Proctection Agency for performing a perfunctory study of artificial turf, including crumb rubber that contains traces of potential cancer-causing chemicals.

The Consumer Product Safety Commission recently announced that the fields are safe, after testing small samples of four artificial fields for lead.

Late last week DeLauro sent a lengthy criticism of the study to the acting chairwoman of the CPSC, Nancy A. Nord, contending that the analysis was circumspect, inadequate and failed to look for the most dangerous compounds.

“It is my understanding that the methodology used by the CPSC study may have been flawed,” DeLauro wrote.

“As such, the report’s conclusion may have been premature, providing less than adequate rationale to conclude that children are safe ... Clearly, additional study is needed before synthetic turf fields can definitively be declared safe,” DeLauro wrote.

Specifically, all four of the fields tested appear to have been made by a single manufacturer, DeLauro wrote.

“It seems questionable for the CPSC to characterize to the American people that all synthetic turf fields in the country are safe,” she said.

Many of the 3,500 artificial turf fields nationally consist of a synthetic fiber underpinning that contains grass-like tufts.

To make the surface feel more like natural ground, tons of crumbled tires are placed between the tufts. The small granules of used tires find their way into players’ clothes, and onto their hands, and inside mouths, noses and ears.

The fields also become extremely hot under a summer sun, and the high temperature makes playing difficult, and increases out-gassing from the crumb rubber.

Nancy Alderman, president of Environment and Human Health Inc. said, “With the Consumer Product Safety Commission having just tested only four synthetic turf fields — and then only for lead — and then declaring all fields in the United States safe to play on — I would say the CPSC needs reforming.”

Late last month the CPSC issued a report, saying, “CPSC staff evaluation showed that newer fields had no lead or generally had the lowest lead levels. Although small amounts of lead were detected on the surface of some older fields, none of these tested fields released amounts of lead that would be harmful to children.”

Preliminary tests by the Connecticut Agricultural Experiment Station found traces of benzothiazole, (an skin and eye irritant); butylated hydroxyanisole (a carcinogen); phthalates, (endocrine analogs that may cause reproductive problems) and other irritating compounds.

“I urge the CPSC to continue to look into all the potential health effects of synthetic turf fields,” DeLauro concluded.

DeLauro also renewed a request to the EPA to complete an in depth study of crumb rubber and its possible toxicity.

DeLauro and state Attorney General Richard Blumenthal issued a joint statement in April calling on the EPA to initiate an independent study.

In June, EPA administrator Stephen L. Johnson wrote to DeLauro, assuring her that the CPSC study would be sufficient.

DeLauro reiterated her request for an EPA study, citing the apparently flawed findings of the CPSC review.
Effort made to renew turf debate
Stamford ADVOCATE
By Brian Lockhart, Staff Writer
Article Launched: 08/04/2008 01:00:00 AM EDT

A lawmaker plans to ask the General Assembly to halt the installation of artificial turf for one year in Connecticut, even as Norwalk High School athletes begin practicing on their new field this month.

State Rep. Kimberly Fawcett, a Democrat whose district includes Fairfield and Westport, wants a moratorium on new fields until the state Department of Environmental Protection concludes an analysis. Nationwide there are concerns that the ground-up tires used to make the fields release harmful substances.

The U.S. Consumer Product Safety Commission last week released a study that concluded that children who play on the fields are not at higher risk for ingesting lead. Older fields posed a greater risk of lead ingestion but did not exceed the threshold, the study found.

But concerns remain that the fields expose children to other heavy metals and to chemicals that can cause cancer.

"The state has been messing around with this for a very long time," said Stacy Prince, a Westport parent. "And this is at least a one-year study. At the same time, kids are playing on these fields - little kids. It's frightening."

But not all parents agree.

In Norwalk, the Common Council backed the installation of artificial turf at the high school with support from parents. Officials are considering installing a second field for Norwalk High School.

Sharon Cadden, a Norwalk High parent, said city officials did their research.

"The field was really worn out. We were experiencing injuries," Cadden said. "There were so many reasons to move forward, and we couldn't find anything concrete to tell us to hold off."
If the DEP study finds cause for concern, the city will respond, Cadden said.

"If they say don't be on it when the temperature of the field exceeds high degrees, then we don't go near it. If the study finds if you breathe in the fumes from the rubber for 40 hours a week it's dangerous, then we don't let the kids on it for 40 hours," Cadden said. "But had anybody seen anything that indicated it was a danger to the students - and we're the parents - we certainly would have said no . . . let's check more. . . . I don't think Connecticut has any great resources that we're going to get a different result."

Fawcett, who plans to ask for the moratorium when the General Assembly convenes in January, prefers caution.

"We shouldn't be putting more of these fields in until we know what they're doing to our environment, our children and our water supply," Fawcett said.

The DEP, state Department of Public Health and attorney general said there is not enough evidence to support a moratorium.

"We have looked at a wealth of data (and) studies that have been done on this topic and did not find there was evidence of significant health risks," health department spokesman William Garrish said. "That said, there were some data gaps, so it's certainly a good idea to study the issue further. But there's no indication to (call for) a moratorium."

Attorney General Richard Blumenthal, who helped secure the $200,000 for the DEP study and whose children play on artificial turf in Greenwich, agreed.

"The state should not be issuing calls for a moratorium when it has reached no conclusion," Blumenthal said.

DEP spokesman Dennis Schain said the agency will hire a company to test fields in Connecticut, though there is no timeline yet.

"We don't want to rush into anything and get something that isn't credible," Schain said.

State Rep. Richard Roy, D-Milford, co-chairman of the legislature's Environmental Committee with state Sen. Edward Meyer, D-Guilford, said a moratorium may not be the way to go.

"I think there's a feeling that the issue of toxicity is controversial enough that it would be viewed as pretty drastic for the state to pre-empt the towns with a moratorium," Meyer said. "I think a moratorium by the state would not be well-received."

It would be tough to order a moratorium on projects that are under way, Roy said.

Both sides have strong arguments, Blumenthal said.

"Local governments have to make their own assessments based on the information available to them, which is more or less what's available to us," he said.
Report goes over like a lead balloon in Westport...
Feds say it's OK for children to play on artificial turf fields
Stamford ADVOCATE
By Wynne Parry, Staff Writer
Article Launched: 07/31/2008 02:42:30 AM EDT

STAMFORD - Playing on artificial turf doesn't put children at risk of ingesting dangerous amounts of lead, according to a study released yesterday by the U.S. Consumer Product Safety Commission.

Elevated lead levels found in two fields in New Jersey prompted Stamford officials to test the 11-year-old field at Boyle Stadium behind Stamford High School and shut it down when results came back high.  The field has been reopened to all but young children.  The pigment of the synthetic fibers in the turf contains lead, particularly in older fields.

Many have opposed proposals for new turf fields in lower Fairfield County, and the study hasn't changed their minds.

Many say lead is not among their concerns because the way the fields are manufactured has changed. They think the real problem lies with the fine tire crumbs used to cushion the fields.  The study looked at about 40 fields around the country to see if a child ingested more than 15 micrograms of lead, the threshold, while playing, said Julie Vallese, a commission spokeswoman.  The older fields posed a greater risk of lead ingestion, but did not exceed the threshold.

Lead was not used in some of the newer fields evaluated, Vallese said.  The fibers in the fields planned for Westhill High School, Lione and West Beach parks will be polyethlene, not nylon like those found to contain lead in New Jersey, according to DeRosa Tennis Contractors Inc., the contractor on the projects.

"We're very pleased they're not finding lead, but the ground-up rubber tires that we're most concerned about never had lead," said Nancy Alderman, president of Environment and Human Health Inc., a New Haven nonprofit group that called for a moratorium on installations of artificial turf fields in Connecticut. "You wouldn't tell children to start smoking just because cigarettes don't have lead."

A study by the Connecticut Agricultural Experiment Station in New Haven found the tire crumbs released at least four compounds under slightly elevated temperatures that can irritate eyes, skin and mucous membranes. The tire crumbs were found to leach heavy metals, including zinc, into water.  Shippan resident Mary Uva became concerned about the fields after she found tire crumbs in her daughter's shoes, clothes and hair after a soccer game.

"The kids are very exposed. They are breathing in the dust," Uva said. "It is a different issue than the lead in the fibers."

Stacy Prince, a Westport parent who has spoken out about the installation of turf fields, said she is more worried about lesser-known harmful substances in the tires.

"They're taking a waste product that is banned in many areas and mulching it up," Prince said. "There's a lot right now that would suggest it's dangerous. No one wants to look at it because it's new."
Battle over home turf
Stamford ADVOCATE
By Lisa Chamoff, Staff Writer
Article Launched: 06/09/2008 01:00:00 AM EDT

In Fairfield County, some parents have contested plans to install artificial turf athletic fields because of worries about the safety of the ground-up tires used as cushioning.

But last month, the Norwalk Common Council approved a $500,000 project to replace Norwalk High School's 8-year-old field with little objection. Parents and school officials in Norwalk said research does not indicate the fields pose a serious health risk, and some say the poor condition of the field, made with the first generation of artificial turf, might be more of a danger.

Marge Costa said her daughter, Sara, a sophomore, tore her anterior cruciate ligament while playing lacrosse in April. It was a pristine spring day, but when Sara planted her foot on the field to change direction during a game, she heard a pop.  In 2006, Sara broke her foot at the beginning of soccer season. Costa said she can't prove that field conditions caused her daughter's injuries, but it gives her more reason to support replacing it with the controversial turf.  Some research indicates the rubber fragments can release carcinogens and heavy metals.

"I'm not concerned about that at all," Costa said. "I'm very happy for the athletes' sake that this field has been approved."

Norwalk High Athletic Director Wayne Mones said the existing artificial field compacted. Soccer balls travel too fast and often go out of bounds.

"You're almost on a rubber surface with no grass," Mones said. "It's bald."

Norwalk High parent Sharon Cadden said she has gone through research, most of it provided by FieldTurf Tarkett, the company that will install the new field.
"We've looked for any research that says this stuff is bad, but we haven't found that it is," Cadden said. "It's probably more dangerous to drink out of heated plastic water bottles than play on these fields."

In Stamford, residents who live near West Beach called for a moratorium on installing two artificial turf soccer fields, and two lawsuits have been filed to stop construction.  New fields are proposed for Westhill High School and Lione Park, but those have caused little controversy.  In Westport, parents last year demanded that the health district end or limit play on artificial turf.

A study by the Connecticut Agricultural Experiment Station in New Haven released a year ago found that under laboratory conditions, the tire crumbs released at least four compounds under slightly elevated temperatures that can irritate eyes, skin and mucous membranes, including one recognized carcinogen. The small pieces were found to leach heavy metals into water.  FieldTurf Tarkett published a booklet that says those tests were not done in conditions under which the turf is used.

At the recommendation of Attorney General Richard Blumenthal, the state Department of Environmental Protection will study artificial turf fields. The study will be funded with $200,000 from a $750,000 settlement of environmental violations by the developer of a Montville shopping center.

Norwalk resident Diane Lauricella, an environmental consultant, did not speak up when the Common Council discussed the turf because she did not look at the data. But she was concerned that much of the information given to council members was from the manufacturer.

"In the past, we've found that manufacturers try to put on the best face of whatever it is they're selling," Lauricella said.  There shouldn't be a rush to install the new field, and the Health Department and the council's Public Health and Welfare Committee were not given the opportunity to look into it, Lauricella said.

"This issue is so controversial that our attorney general thought it was important to get some clear answers," she said.

Nancy Alderman, president of Environment and Human Health Inc., a New Haven group that called for a moratorium on installations of artificial turf fields, said that besides the worries about the tire crumbs, Latex in the tires can cause allergies. In summer, the fields can heat up to 150 degrees.

"We are getting parents that are concerned everywhere," Alderman said.

Stacy Prince, a Westport parent, said the health effects on young children will not be felt for decades. She said she understands that parents want to make sure their children are not at risk of injury on old fields, but they should not assume the material is safe.

"I don't fault the parents," she said. "I just think people are very naively trusting of the corporate world and the government's ability to monitor it."
Another link on this issue...
West Haven officials to consider testing artificial turf 
DAY
Posted on May 17, 4:48 PM EDT

WEST HAVEN, Conn. (AP) -- Health officials in West Haven are concerned about possible health risks at a stadium that uses artificial turf following the recent closings of athletic fields in New Jersey.

Eric Triffin, West Haven's health director, asked high school officials about the surface of its 19-year-old Ken Strong Stadium. He was told the stadium's field is made from the same nylon-based material that was found to contain lead in the New Jersey fields.

Triffin said school and city officials are considering testing the turf.

Two fields in New Jersey were closed last month after state health officials detected what they said were unexpectedly high levels of lead in the synthetic turf. The discovery raised fears that athletes could swallow or inhale fibers or dust from the playing surface.

Pigment containing lead chromate is used in some surfaces to make the turf green and hold its color in sunlight. But it is not clear how widely the compound is used.

West Haven's field is one of four in Connecticut with old artificial turf found to contain high levels of lead. But new artificial turf has been installed in about 80 municipalities in the state and more is on the way.

The new turf is made of a type of rubber created by shredding recycled tires. However, some environmental advocates say the so-called crumb rubber could be hazardous to public health and the environment.

"My guess is when they pull that older field out, they're going to put in the crumb rubber. It means they're trading lead for all the components of crumb rubber," said Nancy Alderman, president of Environment for Human Health Inc. of North Haven.

That puts West Haven officials in a bind.

"Do you spend a lot of money replacing the field, when the surface you're replacing it with has dubious prospects?" Triffin asked. "It's just not simple."

Stamford officials last week closed a stadium after tests showed high levels of lead in samples taken from the old turf. City officials said the field will remain closed until a federal agency can study it further.

Artificial soccer, baseball and football fields are popular because they are durable and eliminate the need for watering, pesticides and mowing. Costs start at about $300,000 and go up depending on the type of turf, the size of the field and other factors.
Turf Testing A Waste Of Time, Money 
By Mike DiMauro, Day Assistant Sports Editor    
Published on 9/6/2007 
   
YOU ARE ABOUT TO HEAR from four local college athletes, two of whom major in environmental studies, who spend five afternoons a week playing sports on artificial turf.

You are about to read from a two-year study from a French environmental agency.

You are about to hear from a state epidemiologist, who studies the transmission and control of epidemic diseases.

After you process what they say, we'll discuss whether state attorney general Richard Blumenthal's pledge of $200,000 for additional testing to turf fields is warranted — or just grandstanding for the cameras, all while shielded by the words, “in the name of public safety.”

A primer: Tests conducted at the Connecticut Agricultural Experiment Station showed that compounds are being released into the air from the rubber pellets from ground-up tires that form the fill material of artificial turf, the same kind found on fields at Montville High School, Connecticut College, Coast Guard Academy and scores of other towns through the state and country.

The nonprofit group Environment and Human Health Inc. (EHHI) conducted the study, calling for a moratorium for any towns to install any new turf fields and for individuals to have limited exposure to such fields pending more research.

There is evidence that field turf is safe.

And still, Mr. Blumenthal pledged $200,000 for more testing.

So now you can decide:

I asked two Coast Guard football players and two Connecticut College field hockey players whether they, or anyone they've ever known, have suffered from “eye, nose and throat irritation, headaches, nausea, dizziness, liver, kidney and central nervous system damage.” The study reported that those are possible effects of the volatile compounds from the pellets released into the air.

Football player Lance Lynch: “I've never heard of that and I've never heard of anyone affected by it.”

Football player John McDonald: “The only thing I notice about the turf is that it's usually hotter. But as far as (the possible effects), I've never heard of anyone affected by it.”

Field hockey player Linnea Camerota, an environmental studies major: “Aside from turf burns, I've never experienced anything like that. Absolutely not. I've never heard of rubber pellets being an environmental threat.”

Field hockey player Jill Mauer, an environmental studies major: “The turf we have has been a major step up. When we had a grass field, we had animal feces, seagull feces ... it was an absolute mess and always flooded. Teams actually came here and turned away. From an athletic standpoint, the turf is more healthy and I feel more safe.”

Mauer and Camerota estimated that they spend five to six days a week on the turf at Conn and at least three to fours hours a week when field hockey is not in season. They believe that a school as environmentally conscious as Conn would never put its athletes at risk.

“I'm proud to say our school would take a stance,” Mauer said. “If something ever stepped on this campus that wasn't right environmentally, there would be red flags all over the place. This is a liberal, liberal campus that definitely puts the environment first.”

Meanwhile, school officials in Enfield read the EHHI report and initially balked at installing synthetic turf fields at its two high schools. Assistant director of public works Colleen Brand e-mailed Brian Toal, an epidemiologist with the state's Department of Public Health (DPH), for an opinion. Toal's response, dated Aug. 15:

“We have reviewed a great deal of the literature on potential human health risk from rubber used in synthetic turf fields. We have not seen any information that would lead us to recommend against installing such fields based on potential chemical exposures or health risk from those using the fields.

“At this time we do not plan on issuing a recommendation against installation of synthetic turf fields. We feel that the information backing up the statements made about compounds being released by turf fields does not warrant immediate concern.”

Finally, a two-year study by ALIAPUR, a French company responsible for used tires (certainly with an interest here) and the French Agency for Environment and Energy Management found “no cause for concern to human health.” The study focused on the quality of water that was transferred to the environment after passing through the rubber pellets and gas emissions from the fields.

There is no denying that erring on the side of safety isn't merely prudent, but the responsibility of lawmakers and elected officials. But to err on the side of safety presupposes that there must be a safety issue in the balance. Based on the evidence — a two-year study, the state Department of Health's opinion and the good health of athletes who participate on synthetic turf — there is no safety issue here.

Any city or town that thinks “further testing” is needed just isn't paying attention.

Such a city or town would have that in common with Mr. Blumenthal, whose heedless waste of $200,000 is a gross swing and a miss.
An explanation for how depression might be cured - go play in the dirt!!!
http://www.livescience.com/humanbiology/070411_happy_bacteria.html


Class President's New Life Shakes A School, Community
The Hartford Courant
By DENISE BUFFA, dbuffa@courant.com
1:57 PM EDT, June 20, 2012

Molly Gambardella, the 18-year-old daughter of a lawyer and teacher, was a straight-A student, senior class president, a member of the National Honor Society, a musician in the high school orchestra, and an assistant soccer coach to younger students.

She looked like a picture of perfection. Except her achievements masked an inner turmoil that lead to serious health issues and, ultimately, a decision that has shaken her family, school and community.  Just three months short of graduation, the teen, suffering from the eating disorder bulimia, left North Haven High School and her parents' home.

Now, she sleeps on a mattress on the floor of a house she shares with others in New Haven. She works on her laptop computer on the stoop, where she completed work for literature and history classes that were pass or fail. She's a political protester and member of a community alliance -- an offshoot of the anti-establishment Occupy New Haven. She jams on her trombone in the living room of the house she shares with others, beckoning other neighborhood musicians to join her. And she dives in Dumpsters with friends for food.

It's a decision she says she doesn't regret.

"I'm extremely happy now," she said. Molly Gambardella says her new way of living is the best things that's happened to her in years, even suggesting it has saved her life. Her father, William Gambardella, a former state lawmaker and town treasurer, seems to agree.

"It doesn't matter what she's doing. As long as she's happy and Molly again," he said.

Gambardella hasn't been to school in three months, but she'll still be allowed to graduate with her classmates on Thursday. She acknowledges that some have questioned why the teen should be allowed to get her diploma. The school has decided she can't give the class president's speech, a decision that triggered an emotional response in her community of protesters and debate in her hometown.

Although Schools Superintendent Robert Cronin and Principal Russell Dallai didn't return requests for comment, the Gambardella family -- including grandmother Alicia Clapp, a member of the North Haven Board of Education -- says the high school senior has completed all her coursework.  Clapp, a teacher for 35 years who's been serving on the North Haven Board of Education for 18 years, said accommodations are traditionally made for students with illnesses, including cancer and Lyme. Molly Gambardella says that she's been suffering from bulimia for six years.

"I would get home and I would pretty much take out all my stress and frustration by eating and then throwing up -- and then I'd go for a six-mile run," she said.

Her older brother had picked up on what was happening -- and convinced Gambardella to tell their parents, which she did. Gambardella says she went inpatient at Hartford Hospital and then into a six-week intensive outpatient program in the fall. She was seeing a psychologist, psychiatrist and nutritionist.  She returned to school, but left in March -- keeping her secret.

"I always felt that people wouldn't get that in North Haven," said Gambardella, who pierced her own nose with a safety pin when she was in eighth grade, right around the time the bulimia started. She stopped wearing a nose ring under parental pressure, but resumed donning one this school year.

She seems concerned that others might think she's trashing North Haven High. She insists she's not. The environment there just wasn't for her.

"I did have friends in high school and I had teachers that I just looked up to," Gambardella said. "But I was also just psychologically in a bad place, mentally and physically."

"Every time I went back there, the bulimia would kick back up," added the teen, who sports wavy, shoulder-length brunette hair that her friend cut dreadlocks out of recently.

Although she bailed out of North Haven High, Molly Gambardella -- who wants to be a fine artist -- was attending the Educational Center for the Arts, a magnet school in New Haven, half the day. As she studied drawing, printing and painting, she met a friend who took her to the New Haven Green to check out the protesters of Occupy New Haven. She felt at home. She felt accepted.

"Immediately, I just fell in love because everyone was so friendly," she said. "They didn't care who you were or what you were all about. It was awesome," she said.

She said her conservative classmates turned their backs on her while the liberal kids applauded but failed to join her. No matter. Her disease released her from its grip.

"Instead of binging and purging, I would just hang out with them," she said. "I didn't feel self-conscious at all. It was just a freeing experience...They were just fighting for something big, just a big picture."

When she discovered some were trying to take control of the movement, Gambardella and others broke off and founded the Appleseed Affinity Group, a community-oriented activist group. Now they live in a house in Fair Haven. Instead of paying rent with cash, they pay with labor, helping to rehab another house down the street.  She's not seeing a therapist. She's not taking medication. She's not in a 12-step program.

"This is my outlet," she said.

Her father recalls how he had seen his daughter go from a happy-go-lucky kid to a belligerent and nasty teen – but then settle into herself again.

"Her whole attitude from six months ago to now has changed 180 degrees," he said.

The teen, who hasn't ruled out college, graduated from ECA on Monday -- a happy occasion for all. Her grandmother said Molly Gambardella was quite creative there, making a gown out of neckties and a chandelier out of three rings, a small light, and some tea bags to represent the Tea Party.

The grandmother said she was "hurt down to the pit of my stomach" when she learned her granddaughter was suffering from bulimia. But she knew the teen was suffering far more.  Gambardella's grandmother and father say they are very proud of the teen. They say Molly Gambardella is keeping in step with the political nature of the family. They both note that the teen's great-grandmother was the first woman to vote in New Haven.

"She's got that as DNA," the grandmother said.

Molly Gambardella plans on attending North Haven's graduation on Thursday, but she's still nervous about it. She feels her peers and some teachers are angry with her for not going to school. She says some North Haven students have been commenting on Facebook.

"They want to trip me during graduation," she said.

She feels some students are angry their senior class president cut out of school. But Gambardella insists she didn't do so until fulfilling her fundraising obligations by, for example, raising funds through a book of advertisements for local businesses.

"Once I fulfilled that, I felt I needed to get out before my head would explode."

Gambardella's grandmother, school board member Alicia Clapp, insists she never even made a phone call to help her granddaughter in school because it would have been inappropriate. She said Molly Gambardella's parents dealt with the situation.  While administrators, in various media rpeorts, have maintained she missed a deadline to submit her speech as class president for review, Gambardella suggests they fear she'll espouse her political views.

She said she's been given the opportunity to deliver the speech at an Occupy Wall Street's convention in Philadelphia on the Fourth of July -- and that it will later be posted on the Occupy Wall Street web site. 
Gambardella says while her mom, dad and grandmother attend her graduation ceremony on the Mike Vanacore Football Field, her new New Haven family plans to watch from nearby.

"They've all come to my art shows at ECA," she said happily. "We go bike riding, Dumpster diving."

If looking into someone's headaches, for example, you had better do a double scan!
Hospitals Performed Needless Double CT Scans, Records Show
NYTIMES
By WALT BOGDANICH and JO CRAVEN McGINTY
June 17, 2011

Long after questions were first raised about the overuse of powerful CT scans, hundreds of hospitals across the country needlessly exposed patients to radiation by scanning their chests twice on the same day, according to federal records and interviews with researchers.

Performing two scans in succession is rarely necessary, radiologists say, yet some hospitals were doing that more than 80 percent of the time for their Medicare chest patients, according to Medicare outpatient claims from 2008, the most recent year available. The rate is typically less than 1 percent, or in some cases zero, at major university teaching hospitals.

Next month, the Center for Medicare and Medicaid Services is expected to release figures for 2009, but according to people who have seen the numbers, the practice of double scanning chest patients has continued.

“When I saw the 2009 numbers, they were the same essentially, and I was disquieted by that,” said Dr. Michael J. Pentecost, a radiologist and Medicare consultant who also reviews claims for commercial clients.

The overuse of scans has been the subject of growing concern in recent years, but a review of the federal data, focusing on a common procedure performed millions of times a year, offers a rare and detailed snapshot of the problem state by state, hospital by hospital.

In 2008, about 75,000 patients received double scans, one using iodine contrast to check blood flow, and one that did not. “If you do both, you bill for both,” Dr. Pentecost said.

Radiologists say one scan or the other is needed depending on the patient’s condition, but rarely both. Double scanning is also common among privately insured patients who tend to be younger.

Double scans expose patients to extra radiation while heaping millions of dollars in extra costs on an already overburdened Medicare program. A single CT scan of the chest is equal to about 350 standard chest X-rays, so two scans are twice that amount.

“The primary concern relates to radiation exposure,” said Dr. James A. Brink, chief of diagnostic radiology at Yale-New Haven Hospital, where double scans accounted for only a fraction of 1 percent of cases. He added: “It is incumbent upon all of us to limit it to the amount needed to make a diagnosis.”

Officials at hospitals with high scan rates said radiologists ordered the extra chest scan figuring that more information is better. In rare instances, the two scans might help a doctor distinguish between tangled blood vessels and a tumor, Dr. Pentecost said.

The Medicare agency distributed the data to hospitals last year to show how they performed relative to each other and to encourage more efficient, safer practices. The review of that data found more than 200 hospitals that administered double scans on more than 30 percent of their Medicare outpatients — a percentage that the federal agency and radiology experts considers far too high. The national average is 5.4 percent.

The figures show wide variation among states as well, from 1 percent in Massachusetts to 13 percent in Oklahoma. Overall, Medicare paid hospitals roughly $25 million for double scans in 2008.

Double scanning is more likely to occur at smaller, community hospitals such as Memorial Medical Center of West Michigan in Ludington. It gave two scans to 89 percent of its Medicare chest patients..

“We aren’t radiologists, but as we understand the practice, it was strictly a matter of physicians, independent practitioners who were doing their best to get to the bottom of what was ailing their patients,” said Bill Kerans, a spokesman for that hospital.

Since 2008, Memorial Medical Center lowered its rate to 42.4 percent in 2010 and to 3 percent in the first part of 2011. “We have made some dramatic changes in protocols and practices,” Mr. Kerans said.

A few large hospitals have had problems as well. St. John Health System in Tulsa double-scanned 80 percent — or 800 of its Medicare outpatients in 2008. “We recognized in late 2008 and early 2009 those numbers were higher than we needed to be,” said Charles Anderson, the hospital’s president and chief executive.

By changing protocols, the percentage of double scans is now “hovering around 5 percent,” Mr. Anderson said. “What that means for us is when a physician orders a scan from a radiology department, the radiologist begins to engage in a conversation with those physicians, talking about what might be a more reasonable and acceptable approach.”

Medicare paid St. John roughly a quarter of a million dollars for the double scans in 2008, but Mr. Anderson said money was not a factor in why they were done. “We are an organization that last year did $75 million in costs of uncompensated care, so we are hardly in it for the money,” he said.

UNC Healthcare in Chapel Hill, N.C., performed nearly 2,000 scans in 2008 and none were doubles. “I would be very surprised as to why that would occur,” said Dr. Paul L. Molina, the hospital’s executive vice chairman of radiology. “Someone’s got to educate me as to why they see the need to do both.”

Carroll Rogé, a spokesman for ETMC hospitals in Texas, three of which had dual scan rates over 60 percent, said independent doctors at those hospitals “hold varying opinions” on the value of the federal data.

“Combining these tests expedites the diagnosis and the care to the patient,” said Dr. Harold Smitson, who helps to oversee radiology at ETMC hospitals in Athens and Fairfield. “These are small and rural hospitals, without a complete range of medical services, which are mandated to evaluate patients quickly and efficiently to determine the need for transfer to a higher level of care.”

The Medicare agency believes hospitals can and should do more to change physician behavior. “Hospitals will say, ‘Wait, we don’t order tests, why are you measuring us?’ ” said Dr. Michael Rapp, who directs the Quality Measurement and Health Assessment Group for the federal agency. But, he added, “Hospitals certainly have the ability to put in policies and to monitor what’s happening.”

Added revenue may not be the reason dual scans are ordered.

“It is because no one has looked at it before,” said Dr. Rebecca Smith-Bindman, professor of radiology, epidemiology and biostatistics at University of California, San Francisco. “This is a brand new quality measure. There are very few of them out there.”

The federal agency plans to use other, similar measurements to rein in what it considers to be unjustified — and potentially dangerous — medical procedures.

“Modifying physician behavior is a hard thing to do,” said Dr. Pentecost, the claims consultant. “And we are doing it. This is a very powerful tool.”
Inspirational story here.
Brain tumor often a mysterious, silent enemy
NORWALK HOUR
By JILL BODACH, Hour Staff Writer
August 9, 2008

Larry Johnson said he didn't know much about brain tumors until his brother was diagnosed with the affliction three years ago.  Frank Johnson Jr. was 53 years old when he was diagnosed with a malignant brain tumor and 56 when he died just a few days ago. He was buried Friday.

"Usually you don't recognize signs or symptoms of something like this when a person is constantly working like my brother was," Johnson said. "It wasn't until recently that he seemed sick at all."

Within the past year, Sen. Edward Kennedy, D-Mass., and journalist Robert Novak were both diagnosed with brain tumors. It isn't until a well-known figure or a loved one is diagnosed that most people think about brain tumors, said Dr. Kesav Nair, an oncologist with the Whittingham Cancer Center.

"A tragic event such as this, striking a prominent figure, has national interest piqued in an ailment we normally do not think about," Nair said.

Of the approximately 41,000 brain tumors diagnosed in the United States each year, about 21,000 are benign; the rest are malignant, according to Nair. He added that brain tumors are the most common malignancy in childhood, and the vast majority of malignant brain tumors occur after age 45 and peak after 65.  There are three types of tumors that present themselves most frequently: meningiomas (tumors in the lining of the brain that are often located on the surface of the brain); glioblastomas multiforme (tumors of the supporting cells of the brain); and malignancies that develop elsewhere -- such as the breast or lung -- which then travel to the brain.

Even benign tumors can be dangerous, said Dr. Eric Mazur, chairman of the department of medicine for Norwalk Hospital.

"Benign tumors can be dangerous because the head has a fixed volume, so you can only put so much in there," Mazur said. "If a tumor is growing in the brain and it cannot be reached, it can put pressure on the brain and cause damage, even if it's not cancerous."

Signs and symptoms of brain tumors vary. Kennedy's tumor was diagnosed after he suffered a seizure. For Novak, the diagnosis followed a car accident where he struck a bicyclist because he said he could not see the bicyclist. With Johnson, he had visual impairment and difficulty walking.

"It started with visual problems, and then one day, maybe about a year and a half ago, he called me because he was feeling numbness in his legs and told me he was having trouble walking, so I called 911," Johnson said.

All of these are symptoms of brain tumors.

"The most common symptoms are headaches and seizures, occurring in more than 50 percent of patients," Nair said. "Other symptoms include visual disturbances, language and expressive difficulty, loss of memory, one-sided weakness and personality changes reflecting specific areas of the brain being affected."

Other brain tumors may not present themselves with any signs or symptoms at all.

"Some can grow and be quite large and be asymtotic," Mazur said. "Compared to other types of cancers, these are pretty uncommon tumors."

The treatment for benign, low-grade and high-grade tumors is primary surgical resection. Frank Johnson's tumor was removed surgically and doctors thought they had removed it entirely. It was later discovered that there was another tumor growing in his lung.  Some tumors are not able to be surgically removed.

"The brain is so densely packed with important things that if the tumor is in the wrong area, it can be inaccessible to surgical resection," Mazur said. "I can't think of another part of the body that is as difficult to get to as the brain."

Another option is chemotherapy or radiation, but these treatments don't always work for brain cancer.

"Chemotherapy doesn't get into the brain tissue as well as it does elsewhere because there is something called the blood brain barrier, which is a protective mechanism that prevents certain fluids from entering the brain," Mazur said.

On a more positive note, the brain does tolerate radiation better than other areas of the body, Mazur said.  There are few known causes for brain tumors, although rare genetic disorders may predispose people to the development of brain tumors.

"Usually if people have one of these disorders, they know it and they know that it might cause a brain tumor," Mazur said.

There are other supposed causes, including geographic location.

"The overall incidence of the disease is rising throughout the industrialized countries, which raises the question of environmental factors, but in the vast majority, the cause is unknown," Nair said.

Recently there has been discussion about the link between cell phones and brain tumors, but there isn't much actual data to support this hypothesis.

"I haven't read all the data, but the information is particularly persuasive as far as I'm concerned," Mazur said. "To put it in perspective, brain tumors are a pretty low likelihood in anyone's life."

BRAIN CANCER SURVIVORSHIP
Via e-mail, we received this release on July 5, 2007:

YOUNG CANCER SURVIVOR MATTHEW ZACHARY APPOINTED TO GOOGLE HEALTH ADVISORY COUNCIL
Zachary to Advocate on Behalf of 1 Million Young Adults Affected By Cancer


BROOKLYN, NY – July 5, 2007 – Matthew Zachary, Founder and Executive Director of The I'm Too Young For This! Cancer Foundation For Young Adults (i[2]y) has been appointed as a member of the newly formed Google Health Advisory Council. Zachary will share i[2]y's experience in engaging its youth culture and young adult constituents through the organization's advocacy innovations, social networks and comprehensive website portal, www.ImTooYoungForThis.org.

The Google Health Advisory Council was created to help Google better understand the problems consumers and health providers face in the healthcare system today. Council members will offer Google feedback on ideas for new products and services to empower consumers with their health care decisions. Zachary joins other experts from provider organizations, consumer and disease-based groups, physician-based organizations, research institutions, and health care policy foundations.

"We are at a tipping point for social change in cancer advocacy and this is a profound opportunity to represent the voices of more than 1 million young adult survivors as Google defines its vision for a global consumer healthcare revolution," said Zachary.

i[2]y has earned accolades from the oncology community for establishing a global presence and filling gaps to rectify public health inequities faced by the young adult population, aged 15-39, now estimated at over 1 million survivors by the National Cancer Institute. The i[2]y initiative, launched in January 2007, has quickly developed an affiliate network of 200 cancer centers, mobilized thousands of survivors into an international social network, organized the first arts coalition of young musician/survivors and produced a pioneering live, weekly, interactive social radio broadcast–The Stupid Cancer Show. i[2]y is widely regarded as the next big thing in advocacy for a grossly underserved, but motivated, population.

"What Matthew and his foundation have achieved in such a short time, clearly indicates the demand to fill an expansive gap in our healthcare continuum," says Dr. Kevin Oeffinger, Director, Living Beyond Cancer: A Program for Adult Survivors of Pediatric Cancer at Memorial Sloan Kettering Cancer Center in New York City. "In concert with their relationship with Google, I am optimistic that the opportunity to fill those gaps is now more tangible than ever."

About i[2]y
The I'm Too Young For This! Cancer Foundation For Young Adults is a global support community for young adults affected by cancer. Our mission is to improve quality of life by providing 'one-stop' access to hard to find resources, peer support and social networks. We use music and the arts to make it hip to be a survivor and talk about stupid cancer by advocating on behalf of more than 200 young adult support resources and more than one million survivors aged 15-39 who are currently living with, through and beyond cancer worldwide. For additional information, please visit www.ImTooYoungForThis.org.
-------------------------------------------------


http://www.stepsforliving.org
In concert at Norfield Church Parish Hall, Matthew Zachary, award-winning pianist and composer, introduced Weston to his organization...

Official website, http://imtooyoungforthis.org.

Want to hear from Matthew as a motivational speaker and 'cancertainer'. Here are those links:
http://matthewzachary.com/speaking.html
http://bureau.espeakers.com/simp/viewspeaker7285


A Cure-All for Jet Lag? Try Caffeine and Naps
NYTIMES
By JOHN SCHWARTZ
Published: April 30, 2008

GOOD news! Last June, researchers in Argentina identified a promising potential treatment for jet lag: sildenafil. You might know the drug by its more common brand name, Viagra.

The study, published in The Proceedings of the National Academy of Sciences, showed that our circadian rhythms, the body’s inner clock, could be shifted with the little blue pill. Sounds as if we will have that jet lag problem solved in no time, right? Or, at least, travelers will have a new excuse to ask their doctors for Viagra.

The press had a grand time with this, of course, but the news is not as clear as the reports might make it seem. The single study only showed effectiveness of sildenafil in hamsters. Will the results be borne out in further studies? Will the drug have the same sleep-shifting effect on humans? Nobody knows. And besides, isn’t that particular drug more closely linked to vacations than to negotiations?

That’s why Mark R. Rosekind, a sleep expert and a founder of Alertness Solutions, a consulting firm in Cupertino, Calif., that helps businesses deal with issues like shift-work alertness and jet lag, said that he is cautious whenever he hears of a purported miracle cure — from over-the-counter homeopathy to hot-off-the-presses research. “I’m open to everything, but I’m a scientist,” he said. “Show me the data.” He wants to see solid scientific evidence to support any product’s promise of being good for what ails travelers...

In fact, experts said, for most trips it might be best to make the most of the alertness you can muster when you need it. That comes down to “naps and caffeine,” Dr. Rosekind said. Studies of pilots showed that a 26-minute nap in flight — while a co-pilot took the controls, of course — increased performance by 34 percent and overall alertness by 54 percent.

Using simple caffeine to raise alertness in conjunction with naps during a trip is a winning strategy, Dr. Rosekind said. Caffeine takes 15 to 30 minutes to work, and an effective nap should be less than 45 minutes, to avoid going into the kind of deep sleep that leaves people groggy. So drinking a cup of coffee just before a nap, he said, can ensure that you will awaken with a little extra zip. The caffeine and nap working together “can actually show a performance boost greater than either one alone,” he said. “It’s not rocket science.”


GO TO COOL NEW WEBSITE HERE

April Weston  FORUM article below gives a different perspective on the same thing...
Teen pill parties growing in town
Greenwich TIME
By Meredith Blake, Staff Writer
Article Launched: 05/25/2008 02:30:14 AM EDT

Placed next to the chips and salsa is a bowl filled with prescription pills. This is how casually some teens view using pain killers or mood-altering drugs at parties.  And although "pharming" or "bowling" parties are not new, they have become a growing problem in town and throughout Fairfield County, according to Stephanie Paulmeno, community health planner for the town Health Department.

"This is a significant public health issue," she said.

The department has been aware of prescription pill misuse for more than two years, working closely with agencies monitoring the problem, but not until recently had the concerns been confirmed by police departments, Paulmeno said.  Richard Stook, a town neighborhood resource officer, said it is difficult for police to uncover the drugs, since pills like OxyContin and Ritalin are easily concealed or disposed of by the time officers arrive at parties. But Greenwich teens themselves have reported their use, he said.

"We're not seeing it ourselves, but when we interview the kids, they are telling us there is a high volume of prescription drug use," Stook said.

In a recent survey conducted by the National Institute of Drug Abuse, one out five teens said he or she had used prescription drugs recreationally.  The highest rate of use is among 18 to 25 year olds, with the numbers increasing significantly each year among 12 to 17 year olds, according to the survey.

"This is an emerging problem," said Wayne Dailey, spokesperson, Connecticut Department of Mental Health and Addiction Services.

One of the major problems is that many teens believe prescription drugs are a safer alternative to illegal drugs, since they have been distributed by a doctor or taken by parent.

"The myth is that it is OK, it's not the same level of danger of other drugs, but that is not the case," said Ingrid Gillespie, director Lower Fairfield County Regional Action Council Stimulants, such as Dexedrine, if taken in high doses can cause paranoia, high body temperatures or an irregular heartbeat. Opioids, like Vicodin, if taken over a long period of time, can lead to physical dependence and addiction, according to the National Institute on Drug Abuse.

Many prescription drugs labels state the dangers of taking more than one medication at a time, or using with alcohol, but most teens ignore this, Paulmeno said.

"Who knows what they are mixing at these parties. The interactions of these drugs can be catastrophic," Paulmeno said.

Teens readily have access to these drugs, either from their parents or friends' medicine cabinets. Many people keep old prescriptions, but this can have dire consequences.

"Parents should keep their prescriptions locked up and dispose of the bottles after use," and Paulmeno.

But teens are becoming more savvy and finding new ways to access these medications, whether its online purchasing, or recycling old prescription bottles, and refilling them, according to Kyle Silver, executive director of the Arch Street teen center.  Silver hears teens frequently talking about using prescription drugs and said they know where to get them, how to transport them and how to conceal them.

"If parents were more aware than it wouldn't be as easy for students to get," he said.

The difficulty town agencies face is determining how widespread the problem is. There has been no town-wide survey conducted and a state-wide survey is outdated by two years, according to Dailey.

In 2005, prescription drug misuse was rated the sixth most common drug problem in Connecticut, after use of cocaine, heroin, marijuana, tobacco and alcohol, according to a survey conducted by the State Epidemiological Workgroup.  But there is evidence that it is growing and surpassing cocaine and heroin, because it is so easily accessible, but there is no direct statistical information to substantiate this, Dailey said.  Officials work closely with drug and alcohol treatment providers, emergency room doctors, parents and even schools who tell them that this is becoming a more serious problem, said Dailey.

Despite the lack of specific data, statistics show that individuals in a higher- socioeconomic status are the ones most often abusing prescription pills, making Greenwich a community at risk, according to Gillespie.

The Health Department and other agencies are looking to survey teens on this issue and find out who and why they are engaging in this behavior. If officials can learn more than perhaps more can be done to prevent the rise of teens hospitalized for this emerging problem, Paulmeno said.

"If we have more information, than more can be done to address it," she said.
Weston teens tell parents what's on their minds
Weston FORUM
by Patricia Gay
Apr 30, 2008

Weston teens want parents to listen more and offer support without being intrusive.  So said a panel of Weston High School students at a parent-teen discussion forum on Wednesday, April 23 at the Norfield Church Parish Hall.  The forum was held in an effort to help bridge the gap between parents and children to create a safer, more open environment; and to educate parents on what it is like to grow up in this day and age.

The panel was comprised of members of the Youth Leadership Council of the Alcohol and Drug Awareness Program (ADAP) of Weston, and included Danny Goldberg, Dylann Katz, Jordan Masarek, Danielle Tolkin, Ryan Seymour, Khadija Lalani, Meg Sanborn and Ross Karlan.

ADAP has approximately 80 student members in the Weston schools.  John McGeehan, who oversees the youth leadership council, served as moderator of the forum.  He thanked Mike Foster, the president of the Booster Club, for the club’s support in sponsoring the forum.

The panel answered a series of questions posed by Mr. McGeehan and parents in the audience on the topics of transition from middle school to high school, social pressures and expectations, the parent-child relationship, and drug and alcohol use.

Transition

The first topic was about social and academic changes students face in the transition from middle school to high school.

Danny said being in a new school was a bit awkward at first. But he said it gave him a greater sense of maturity.  He also noticed things are more competitive in high school and there are greater challenges than there were at the middle school.

Jordan said being with older kids opened her up to new things. She encourages new students to take part in a high school sport because being part of a team is like being part of a family.

Danielle said in high school, kids have an opportunity to become themselves and meet new people. “There is more diversity in high school,” she said.  Academically, there is a more intense workload and competition in high school, said Ross. He said kids are often comparing their grades and grade point averages. “But, there also is an opportunity to choose your own classes,” he said.

Khadija said there is more pressure on students to do well, and sports are more competitive, too. “There are also social pressures and a lot of influence from upper classmen,” she said. She also noticed more drinking in high school than middle school.

Social pressures

The panel discussed the pressures they face in high school and how they deal with them.

Dylann said she felt pressured in choosing who to hang out with. “You find the kids you have things in common with. High school is not all about the work. You need time to have some fun too,” she said.

Meg said teens learn pretty quickly in high school that teachers won’t hold their hands during the academic process. “They won’t remind you to turn in your work,” she said.

Ross said parents can help by promoting independence. “Allow your kids to explore who they are. Pushing kids just adds to pressure,” he said.  Jordan said one of the things she likes is that her friends feel comfortable talking to her parents.

Ryan suggested that one way parents can keep tabs on their kids is not to approach them. “Let the kids approach you to discuss things,” he suggested.  From the audience, Dawn Egan asked what would be a reasonable curfew for freshmen.

Danielle suggested 11 p.m. “Parents should also use discretion and let kids stay out later if the occasion warrants it,” she said.

Another parent asked what students think about the possibility of changing the start time of school a half hour or 45 minutes later to allow them more time to sleep.  Ryan thought the extra sleep time in the morning would be good because he sometimes has trouble going to sleep at 11:30 and then getting up early.

Khadija, wasn’t so keen on it if meant after school activities such as sports would run later.  Danny said kids should adjust their schedule to get more sleep.

Parent-Child relationship

The next issue was how parents could become more approachable and relate better with teens.

Ross said his parents support what he does and aren’t judgmental. “If I fail a test, they say try to do better next time.”

Ryan said his parents allow him to have free time on the weekend.  Time management is an issue for Jordan, so she said she is a big supporter of “Mental Health” days. She said her parents also encourage her to take power naps when her workload becomes overwhelming.

Danielle said teens put a lot of pressure on themselves. “Treat kids as individuals. Just listen to them without making judgments. Ears are the most important thing you can give to your child,” she said.

Jordan said one way to get kids to talk is be their friend. “Remember, you were once a teenager also,” she said.

Danny said some parents fail to realize there is a lot of pressure on students and they make kids ashamed of themselves. “It is better to support them than criticize them,” he said.

“Don’t compare older and younger siblings. Let each child be different,” said Dylann.

The panel said parent gossip — when parents tell others about things the teens tell their parents in confidence — can be damaging to the child-parent relationship.

Drugs and alcohol

The discussion then turned to the topic of drugs and alcohol.

Ryan said there is a lot of peer pressure during freshman and sophomore years on kids to drink or use drugs. He said he sees younger kids drinking in order to impress older kids.  The panel said children are affected by their parents’ behavior with drugs and alcohol.  Danny said when kids are growing up, what their parents do sets their comfort level.

“Adults have a great influence on kids,” said Ross. “If adults are drinking heavily, it sets an example.”

Dylann said parents need to look at where they keep alcohol in the house. “How available is it? Do they lock it away?” she asked.  Members of the panel also said they have been to or heard about unsupervised and supervised parties in Weston where alcohol was served, and it was not that uncommon.

A parent asked what illegal substances kids were experimenting with in Weston.

The panel collectively responded that marijuana use was big, along with alcohol, and prescription medication such as Ritalin and Adderall, which are prescribed for Attention Deficit Disorder.  Teens also take energy drinks along with Ritalin and Adderall for extra stimulation.

At the end of the discussion, parents thanked the teens for being candid and helpful.

Great article by Patty Gay!
Students give the straight dope about drug use in Weston
Weston FORUM
by PATRICIA GAY
Jan 17, 2007
 
Nikki Phillips was a beautiful star athlete, bright and personable, who seemed to have everything going for her. Yet in a moment, she was gone.

A popular member of the Weston High School class of 2006, Nikki, 18, died accidentally from an apparent drug overdose in November while in her dorm room at Florida Atlantic University. The news came as a huge shock to Nikki’s family, friends, and classmates.

A memorial service was held at the Unitarian Church for Nikki on Saturday, Jan. 6. While the service provided some closure, there are still many grieving Nikki’s loss.

Among those trying to get a handle on things are Weston High School students who belong to a group called ADAP (Alcohol and Drug Awareness Program).

After Nikki’s death, the group, which has about 50 members, met to discuss their feelings. “We wondered if there was something we could or should have done,” a friend of Nikki’s said.

The Forum recently spoke with several ADAP students about drug use among Weston teens. For purposes of this story, the students will be referred to as Adam, Beth and Carol (not their real names).

Carol is quick to point out that ADAP is not a drug or alcohol abstinence group. “As the name implies, ADAP is an awareness program; it helps raise awareness about the effects of alcohol and drugs on teens,” she said.

Drug of choice

Although an exact number is unquantifiable, Adam, Beth and Carol said a lot of Weston teens regularly use drugs and drink alcohol. According to Adam, hard drugs such as cocaine and heroin are used by only a small percentage of the population. More common is marijuana and alcohol use.

But all three agreed there is one drug that is even more popular with Weston teens these days.

“Adderall is the drug of choice in Weston,” Beth said.

Adderall?

Yes, Adderall — an amphetamine-based stimulant prescribed by doctors to treat attention deficit disorder.

It comes in pill form, and, when taken responsibly by patients who need it, Adderall helps improve attention span and decrease impulsivity.

“It’s the ideal Weston drug. It keeps you up so you can study. It curbs your appetite. And it’s legal,” said Carol.

But Adderall has also been called “Ivy League crack.”

Teens abuse Adderall by taking more than the recommended dosage and mixing it with alcohol, or crushing and snorting it like cocaine. It helps them stay awake through crunch times as they prepare for placement tests like the SATs and school exams. They can easily obtain Adderall through a prescription, or buy it illegally for $5 a pill.

Because it is a prescription drug, Adderall abuse often flies right under the radar of parents.

“There are so many kids in Weston who go to psychiatrists, it’s really easy to get a prescription for Adderall,” Beth said.

But while Adderall may have some benefits initially to the teens, its abuse has nasty side effects and a profound downside. “It really messes up my friends,” Beth said. “They become like machines. They don’t talk and they stop eating.”

Adderall is also the drug of choice of girls with eating disorders who often take it in order to stop eating and lose weight. “Adderall is Weston’s crystal meth,” said John McGeehan, facilitator of the ADAP group.

Why?

So why are Weston teens taking drugs in the first place? In an affluent town that boasts home sales that average more than a million dollars, and a school system where a large number of seniors get early college admission decisions, what is the appeal of drugs?

While there is no definitive answer, the students had several insights.    

“Parents have no idea what their kids are doing,” Adam said. “Adults are often so caught up into their own little worlds that teens are unsupervised and feel neglected. Some kids don’t have a good relationship with their parents, and parents turn a blind eye to what the kids do,” he said.

When a teen is caught using drugs, Adam said, the typical reaction in Weston is to send the kid to a drug rehabilitation program, often out of state. “A lot more kids go to rehab in this town than anyone knows,” he said.

Another reason for drug and alcohol use, according to Carol, is boredom. “There’s not much to do in Weston, and alcohol is a social lubricant,” she said.

And there’s a feeling of invincibility that most teens have. Carol has noticed that “designated drivers” are not common these days. “Most kids just take a chance and drive drunk,” she said.

Drugs also help teens deal with the stress of feeling as if they must achieve top test scores. The college admission process puts a lot of pressure on the students to perform.

“Almost all kids in Weston have private tutors,” Beth said. “That’s why we do so well on the tests. It’s not what we are taught in schools, it’s how the tutors teach us to take tests like the SATs.”

“The downside to tutoring,” said Adam, “is that you forget what they taught you, you don’t retain it.”

All three said they had horror stories about how the pressure to perform and get top grades badly affected someone they knew. “This is why some kids take Adderall, this is why some girls get eating disorders. The pressure is horrible,” Beth said.

Teens also learn by example. In some Weston households, there is heavy marijuana use by parents, Carol said. “They not only use it, the parents grow it, too,” she said.

Awareness

There is help available in Weston for teens trying to cope with drugs. Currently, 50 students, half boys and half girls, in grades nine through 12 participate in ADAP.

The group is facilitated by John McGeehan, a clinical social worker and substance abuse specialist. He meets with the students monthly on such topics as tobacco, prescription medicines, legal and illegal narcotics, eating disorders, substance abuse, drug dependency, and how to help others.

Each year, the group holds the Mountain Laurel Dance, a sober dance with a Breathalyzer test administered at entry. ADAP also sponsors Red Ribbon Week, a national alcohol prevention program, in which students get shopping discounts at Weston stores with red ADAP cards.

Last year, ADAP and Weston High School hosted Grim Reaper Day to promote alcohol awareness. Students took on the roles of real teen victims of alcohol-related deaths.

Beth said ADAP has helped her become much more educated about the pitfalls of drugs. “I have information I can pass on to someone that may prevent them from making a bad choice,” she said.

Mr. McGeehan is hoping to set up an ADAP parents group in the spring to address parental concerns. He is also opening a private practice in Weston in mid-February that will specialize in adolescents and individual and family counseling.

In the schools

Lynne Pierson, superintendent of Weston schools, acknowledged there are drug issues at Weston High School. “If we have one student abusing substances, it is one student too many from my perspective,” she said.

She is very thankful for organizations like ADAP. “I think we as adults are responsible for our students and have a responsibility to think more seriously about whether we are doing enough to address this issue. It is time for us to reflect and give thought to the efforts we have made and perhaps redouble our efforts and think of additional strategies to keep kids safe,” she said.

She credited the Weston Police Department and the town’s social services staff for assisting with teen drug issues. “It’s a collective effort. We have some good interventions and programs,” Dr. Pierson said.

Weston Detective Carl Filsinger said there have not been many drug arrests in Weston over the last four years.

“From 2002 to present, there have been a total of 28 narcotics complaints. Of those, 18 resulted in arrests, and of those, 11 were for kids under the age of 18,” he said.

In 2004, three juveniles were arrested at the high school for marijuana possession.

Detective Filsinger was also aware of a recent arrest in Westport, where two 18-year-olds and one 16-year-old, all from Weston, were arrested for possession of marijuana and drug paraphernalia.

When it comes to teen drug use, he believes Weston has problems like every other town and the schools are doing a good job handling drug awareness.

“The health teachers and counselors have a great deal of knowledge, and the high school principal, Rose Marie Cipriano, has taken a very proactive approach by encouraging things like Grim Reaper Day,” Detective Filsinger said.

Detective Filsinger was involved with ADAP for more than 20 years, before recently joining the Commission on Children and Youth. His commitment to teens and drug awareness stems back to an incident that happened in 1981.

“A 16-year-old boy had too much to drink and died in his sleep. That memory sticks with me,” he said. 



Neurofibromatosis
Ending neurofibromatosis through research - help to solve this puzzle.  A disease beginning at birth for those afflicted...help find a cure!


Norwalk Hospital Announces...
 
May 15, 2010 is the date of the Whittingham Cancer Center's  Annual Benefit Walk/Run. We hope to have many of you participating and/or donating to the event as sponsors.

We are excited that there is a unified effort on behalf of Weston to raise money to support the wondrous things that Norwalk Hospital does for our community in treating and preventing cancer.  To register to walk or to sponsor someone go to:  http://www.norwalkhospitalfoundation.org/NetCommunity/Page.aspx?pid=360

Click on the left of the page, "Donate to a Team" or "Sponsor a Walker".  When prompted to join a team or to donate, choose "Team Weston Kiwanis."   The walk is easy, in a beautiful spot and the atmosphere is fun. You will feel good participating!!



Breast Cancer:
4th place finisher of the Iditarod 2006, DeeDee Jonrowe, a breast cancer survivor;  she started the '03 race three weeks after finishing chemotherapy!  Finished #4 in Iditarod 2006!




CANCER WALK DONATIONS ALWAYS WELCOME, ANY TIME. WITH LOVE, AT NORWALK HOSPITAL
http://www.norwalkhospitalfoundation.org/NetCommunity/Page.aspx?pid=432&frsi
An enemy that never relents and gets closer all the time - please click on the picure-link above left to read of events nearby Weston (Sunday, October 16, 2005 in Westport, the 2012 event above, right).  Also, Avon contributed to research (10 cents) in 2005 every time you clicked HERE.



LINK TO WWHD WEST NILE INFO HERE.




...Aided by global warming and globalization, Castiglione di Cervia has the dubious distinction of playing host to the first outbreak in modern Europe of a disease that had previously been seen only in the tropics.

As Earth Warms Up, Tropical Virus Moves to Italy
NYTIMES
By ELISABETH ROSENTHAL
Published: December 23, 2007

CASTIGLIONE DI CERVIA, Italy — Panic was spreading this August through this tidy village of 2,000 as one person after another fell ill with weeks of high fever, exhaustion and excruciating bone pain, just as most of Italy was enjoying Ferragosto, its most important summer holiday.

“At one point, I simply couldn’t stand up to get out of the car,” said Antonio Ciano, 62, an elegant retiree in a pashmina scarf and trendy blue glasses. “I fell. I thought, O.K., my time is up. I’m going to die. It was really that dramatic.”

By midmonth, more than 100 people had come down with the same malady. Although the worst symptoms dissipated after a couple of weeks, no doctor could figure out what was wrong.

People blamed pollution in the river. They denounced the government. But most of all they blamed recent immigrants from tropical Africa for bringing the pestilence to their sleepy settlement of pastel stucco homes.

“Why immigrants?” asked Rina Ventura, who owns a shop selling shoes and purses. “I kept thinking of these terrible diseases that you see on TV, like malaria. We were terrified. There was no name and no treatment.”

Oddly, the villagers were both right and wrong. After a month of investigation, Italian public health officials discovered that the people of Castiglione di Cervia were, in fact, suffering from a tropical disease, chikungunya, a relative of dengue fever normally found in the Indian Ocean region. But the immigrants spreading the disease were not humans but insects: tiger mosquitoes, who can thrive in a warming Europe.

Aided by global warming and globalization, Castiglione di Cervia has the dubious distinction of playing host to the first outbreak in modern Europe of a disease that had previously been seen only in the tropics.

“By the time we got back the name and surname of the virus, our outbreak was over,” said Dr. Rafaella Angelini, director of the regional public health department in Ravenna. “When they told us it was chikungunya, it was not a problem for Ravenna any more. But I thought: this is a big problem for Europe.”

The epidemic proved that tropical viruses are now able to spread in new areas, far north of their previous range. The tiger mosquito, which first arrived in Ravenna three years ago, is thriving across southern Europe and even in France and Switzerland.

And if chikungunya can spread to Castiglione — “a place not special in any way,” Dr. Angelini said — there is no reason why it cannot go to other Italian villages. There is no reason why dengue, an even more debilitating tropical disease, cannot as well.

“This is the first case of an epidemic of a tropical disease in a developed, European country,” said Dr. Roberto Bertollini, director of the World Health Organization’s Health and Environment program. “Climate change creates conditions that make it easier for this mosquito to survive and it opens the door to diseases that didn’t exist here previously. This is a real issue. Now, today. It is not something a crazy environmentalist is warning about.”

Was he shocked to discover chikungunya in Italy, his native land? “We knew this would happen sooner or later,” he said. “We just didn’t know where or when.”

It certainly caught this town off guard on Aug. 9, when public health officials in Ravenna received an angry call from Stefano Merlo, who owns the gas station.

“Within 100 meters of my home, there were more than 30 people with fevers over 40 degrees,” or 104 Fahrenheit, said Mr. Merlo, 47. “I wanted to know what was going on. I knew it couldn’t be normal.”

August is not the season for high fevers, Dr. Angelini agreed, and within days of interviewing patients she was intrigued.

“The stories were so similar and so dramatic,” she said. “But we had no clue it was something tropical.”

Hard-working shopkeepers could not get out of bed because their hips hurt so much. Able-bodied men could not lift spoons to their mouths. (Months later, many still have debilitating joint pain.)

From the start, doctors suspected that the disease was spread by insects, rather than people. While almost all homes had one person who was ill, family members seemed not to catch the disease from one another.

They initially focused on sand flies, since the disease clustered on streets by the river.

Canceling their traditional mid-August vacations (in Italy, a true sign of panic), health officials sent off blood samples, called national infectious-disease experts, searched the Internet and set out traps to see what insects were in the neighborhood. The first surprise was that the insect traps contained not sand flies but tiger mosquitoes, and huge numbers of them.

The scientific survey confirmed what residents of Castiglione had come to accept as a horrible nuisance, though not a deadly threat.

“In the last three or four years, you couldn’t live on these streets because the mosquitoes were so bad,” said Rino Ricchi, a road worker who fell ill, standing at the entrance to his neatly tended garden, where mosquito traps have now replaced decorative fountains. “We used to delight in having a garden or a porch to eat dinner. You couldn’t this year, you’d get eaten alive.”

Said Dr. Angelini: “They were treating the mosquitoes like an annoyance. They knew that mosquitoes could spread tropical diseases but they had peace of mind because they knew this didn’t happen in Italy.”

Ravenna immediately set about killing the bugs in the hopes of containing the epidemic. Workers sprayed insecticides and went into each family’s garden, emptying flower pots, fountains and the rainwater collection barrels to remove the mosquitoes’ breeding ground.

By early September, there were no new cases in Castiglione di Cervia. But there were a number of mini-epidemics in the region — in Ravenna, Cesena and Rimini — set off by tiger mosquitoes there. Each was controlled in the same way.

By that point, the doctors had cataloged the patients’ symptoms and tried to match them to mosquito-borne diseases.

“We realized,” Dr. Angelini said, “we were seeing a photocopy of an outbreak on Réunion,” a French island in the Indian Ocean where more than 10,000 people have contracted chikungunya in the last two years. Blood tests confirmed the diagnosis. By summer’s end, home-grown chikungunya had been diagnosed in nearly 300 Italians.

Chikungunya is spread when tiger mosquitoes drink blood from an infected person and, if conditions are right, pass the virus on when they bite again. Tiger mosquitoes first came to southern Italy with shipments of tires from Albania about a decade ago but their habitat has expanded steadily northward as temperatures have risen.

But the doctors were baffled by how chikungunya made its way into mosquitoes in northern Italy since no one in Castiglione di Cervia had been abroad. In the past two years France, especially Paris, has had a number of imported cases of chikungunya, in travelers returning from Réunion. But the disease has never spread in France, because the mosquito cannot thrive there yet.

Eventually investigators discovered a link: one of the first men to fall ill in Castiglione di Cervia had been visited by a feverish relative in early July. That relative, an Italian, had previously traveled to Kerala, India. Chikungunya traveled to Italy in his blood, but climatic conditions are now such that it can spread and find a home here.

Now it is winter in Castiglione di Cervia, near freezing as the sun went down on a recent evening and Christmas lights glowed across the piazza. There are no mosquitoes now.

But dozens of residents still suffer from arthritis, a known complication of chikungunya.

Mr. Ricchi, the road worker, says he still has trouble clenching his fists, and his left ankle has horrible pains. Three people in the town died after getting the virus, Mr. Merlo said, although all of those victims had other illnesses as well.

From the start, townspeople noticed that the very elderly never got the disease. Now it makes sense: “If all you do is walk the 50 yards from your home to the church, there’s not much chance to get bitten,” said Mr. Ciano, the retiree.

But the biggest mystery is whether chikungunya will emerge here next summer. In the tropics, it is a year-round disease, since the mosquitoes breed continually. But the virus can winter over in mosquito eggs, too, and no one knows if there are reservoirs of sleeping eggs in some pool of water in Italy.

With climate change at hand, Dr. Bertollini said, chikungunya will surely be back somewhere in Europe again.


The new strain of Cryptoccus gatti - PLOS Pathogens (l);  deadly fungus tornado aftermath.

Deadly Fungus Strikes Joplin Tornado Survivors, Volunteers
YAHOO
William Browning
Thu Jun 9, 2011 2:16 pm ET

The Greene County (Mo.) Health Department has issued a memo to health care workers who are treating injured victims of May's deadly Joplin tornado, warning them that a powerful fungus has infected patients' wounds.

The Springfield News-Leader reports as many as nine cases have been reported in tornado victims across the area in various hospitals. Once the aggressive fungus -- called zygomycosis -- enters the body, it causes the death of infected cells. Three or four patients, who otherwise would have survived their wounds, have died from it.

If the fungus stays in a limb, like an arm or leg, some treatments have necessitated amputation to save the patient. Others with wounds near the head weren't so lucky -- as soon as brain tissue started dying, it was too late to save the patient.

The National Institutes of Health says this rapid form of infection most often occurs in patients with suppressed immune systems. One study in 2009 noted a diabetes patient who died of the fungal infection at age 48. Despite being treated early, the man's health rapidly declined as the fungus spread through his lungs.

Infections spread through the blood and affects blood circulation. It is unknown how many people may be suffering from infections, but the problem doesn't stop with those injured by the tornado.

KYTV in Springfield reports those helping with cleanup efforts may become scratched by nails or splinters and any fungus residue on those objects may infect someone.

Anyone with diabetes should be extremely careful. The National Institutes of Health lists severe symptoms of the infection: fever, headache, sinus pain, and swelling. Complications that can arise from these fungal infections include nerve damage, blindness, blood clots to the brain and lungs, or even death in extreme cases.

Cases of the deadly fungal infection have shown up in massive disasters before such as the 2004 tsunami off the coast of Indonesia. Health officials in Greene County stated in their memo that this particular infection is "invasive" and that aggressive treatment may be needed "within 24 hours" of reoccurring symptoms.

Any patients suspected of having this infection have been told to seek the guidance of a trauma surgeon or the infectious disease doctor on call.
Deadly new fungus strain rolling across Northwestern U.S.
By Ethan Sacks, DAILY NEWS STAFF WRITER
Originally Published:Friday, April 23rd 2010, 1:39 PM
Updated: Friday, April 23rd 2010, 2:09 PM

A mysterious new strain of airborne fungus that has mystified scientists is rolling through the Northwestern U.S. and Canada, leaving at least six people dead in its wake.

A study found that the new strain of Cryptoccus gatti, previously native to tropical and subtropical regions like Australia and South America, is spreading through Washington and Oregon and heading towards Northern California, National Geographic reported.

"The alarming thing is that it's occurring in this region, it's affecting healthy people, and geographically it's been expanding," study co-author Edmond Byrnes, a graduate student at Duke University, told the magazine.

Experts are baffled as to how the fungus reached North American and how  it could survive in a colder climate.

Even more worrisome for health experts are reports that the victims had relatively healthy immune systems, according to National Geographic. Twenty one known cases have been recorded in humans, and six have been fatal.

A 1999 outbreak of a similar strain of the fungus in British Columbia, Canada,  had a much lower mortality rate, killing 19 out of 218 recorded victims.

There is currently no vaccine for the fungus strain, which causes an infection which may not display symptoms -- including a bad cough and shortness of breath - until months after exposure.

"The enhanced virulence of isolates from the outbreak region, when compared with those from other regions, suggests that the genotypes circulating in the Pacific North West are inherently increased in their predilection to cause disease in mammalian hosts," the study authors wrote in the April 22 issue of the scientific journal, PLOS Pathogens.


CHINA REGIONS MAP HERE.

Click here for news of further spread in China (14 April)...

 5 April 2013 Last updated at 07:05 ET
Shanghai closes poultry markets over bird flu
I-BBC

Chinese officials in the city of Shanghai have ordered the temporary closure of its poultry markets due to the H7N9 bird flu outbreak.  A spokesman for the city authorities said the decision was taken on grounds of public safety.  The city has already begun a mass slaughter of poultry after the virus was discovered in pigeons at a market.

Six people have died in this latest outbreak. The H7N9 virus is a form of avian flu not seen before in humans.

China has officially confirmed 14 cases and six deaths due to H7N9 infection as of Friday, the World Health Organization (WHO) said in a statement.  The cases are reportedly from eastern China, including in Shanghai and Zhejiang province.

WHO says there is currently no evidence of human-to-human transmission.

"We have 14 cases in a large geographical area, we have no sign of any epidemiological linkage between the confirmed cases and we have no sign of sustained human-to-human transmission," WHO spokesman Gregory Hartl said in Geneva.

The latest fatality was a farmer, 64, who died in Zhejiang province, state-run media say.  Four of the bird flu fatalities and six of the 14 cases have been recorded in Shanghai.  The city is also monitoring another person who was in close contact with one of those who died after showing flu-like symptoms.  Shanghai health official, Wu Fan, was quoted by Agence-France Presse news agency as saying that the person tested negative for H7N9.

"There is no possibility of spreading the infection overseas," Wu Fan also told a press conference.

Officials ordered the slaughter of at least 20,000 birds starting late on Thursday after the virus was detected in pigeons sold in Huhuai market.  The market was sealed and police stood watch as workers disinfected the areas, reports say.

Xu Wei, a spokesman for the Shanghai government, said trading of live poultry will be suspended on Saturday
Alarm Grows in China as Flu’s Death Toll Rises to 6
By ANDREW JACOBS, NYTIMES
April 5, 2013

BEIJING — With confirmation that a sixth person has died from a mysterious avian-borne virus, Chinese officials escalated their response on Friday, advising people to avoid live poultry, dispatching virologists to chicken farms across the country and slaughtering more than 20,000 birds at a wholesale market in Shanghai where the virus, known as H7N9, was detected in a pigeon.

News of the outbreak dominated China’s main Internet portals. There were photographs of workers in white coveralls carrying out the culling in Shanghai and recommendations that people take banlangen, an herbal cold remedy that is a mainstay of Chinese households. Anxious residents have been crowding emergency rooms at the first sign of respiratory problems. And at a KFC restaurant in Beijing, employees stood idle as mounds of fried chicken went largely unsold. “They say it’s O.K. to eat cooked chicken, but I’d rather not take the chance,” Zhang Minyu, 41, a housewife, said as she coaxed her young son to instead order a soft-serve ice cream.

Roughly 10 years after Severe Acute Respiratory Syndrome, or SARS, began here and spread across the globe, infecting more than 8,000 people and killing nearly 800, the deadly influenza outbreak is testing a government known for its lack of transparency and reluctance to divulge damaging news. The timing has not helped: The Chinese public have already been outraged by record-level air pollution this year, and frustrated by the government’s apparent inability to determine the source or cause of deaths of more than 16,000 pigs found floating last month in the river that supplies drinking water for Shanghai.

Although some critics have questioned why it took so long for officials to publicly announce the outbreak of the H7N9 virus, public health experts have so far commended the government for responsiveness and transparency in the five days since officials identified the first victims. “It was the Ministry of Health and Family Planning that first came to us and volunteered the information,” said Gregory Hartl, a spokesman for the World Health Organization in Geneva. “Their response has been excellent.”

Health officials around the world are nervously monitoring the outbreak, which has killed nearly half of the 14 people in whom the virus has been diagnosed. What they fear most is that the disease will mutate so that it can spread from human to human, but there has yet to be a confirmed case of transmission between humans. However, the state media on Friday reported that Shanghai officials had placed in quarantine a person with flulike symptoms who had contact with a victim of H7N9.

Experts say the virus appears to respond to existing influenza medications like Tamiflu and Relenza. In the United States, federal health officials on Thursday said they had begun working on a vaccine for H7N9.

At the United States Centers for Disease Control and Prevention’s first news conference about the H7N9 outbreak, its director, Dr. Thomas Frieden said that there was close cooperation between his organization and its Chinese counterpart that had helped enable China to post the sequence of the new virus on a public database. He said Americans planning to go to China should still go, but follow longstanding recommendations to avoid birds and other animals.

John Oxford, a professor of virology at Queen Mary, University of London, warned of a potential pandemic should H7N9 undergo a mutation that allows human-to-human transmission. “On my earthquake scale, I’m quite concerned because influenzas have a greater history of emerging and spreading,” he said.

His worries were heightened, he said, by the relatively high fatality rate and the virus’s apparent spread through poultry without any evident signs of illness. “If a flock of chickens or ducks get H5N1, it will kill them and set off alarm bells, but this virus seems to be a bit more tricky,” he said, referring to another avian virus that since 2003 has decimated poultry stocks in Southeast Asia and killed more than 300 people.

Even the government acknowledges that SARS was a public health debacle. Chinese authorities tried to conceal the outbreak, hiding sick patients from the World Health Organization, whose members were barred for five weeks from visiting Guangdong Province, the epicenter of the outbreak. The secrecy, experts agree, allowed the virus to spread within China and across the globe.

Writing on his microblog account, Yu Shenghai, a researcher at the China Economic Research Center, warned the authorities against hiding information about the current outbreak. “I hope the government won’t be self-deceiving and mislead ordinary people,” he wrote. “We learned a lesson from SARS with a cost of blood. A nation is hopeless if it doesn’t recall its past, and a government is incompetent if it doesn’t reflect on its history.”

Shi Da contributed research from Beijing and Donald G. McNeil Jr. contributed reporting from New York.
I-BBC W.H.O. SWINE FLU WORLD REACH MAP, 27 APRIL '09; NYTIMES UPDATING OF MAP - LINK

October 2009 news from U.S.A.
News from CT;
CHINA:  In 2013 in China, H7N9, chicken to human;
Mexico: 103 dead - 20 confirmed to have died from swine flu, 18 confirmed ill with swine flu
United States: 20 confirmed cases of swine flu
Canada: 6 confirmed cases
Spain: 1 confirmed case
UK, Spain, Israel, Brazil, Australia and New Zealand: suspected cases being tested

Op-Ed Contributor
What We Learned From H1N1’s First Year
By RICHARD P. WENZEL
April 13, 2010

Richmond, Va.

ONE year ago today, a government worker in Oaxaca, Mexico, became the first person to die of swine flu. At the bedsides of other men and women struggling to stay alive in Mexican critical care units, we clinicians noticed early on that this novel H1N1 flu virus diverged from influenza’s usual pattern of activity in striking ways. It began in the Northern Hemisphere, not in Asia, and in mid-spring, not late fall or winter. It also had a worrying predilection for children and young adults, not the elderly and newborns.

In the months after those first deaths, the virus ignited a global pandemic. While the epidemic never became as deadly as we initially feared, it was not as mild as some experts now believe. What’s more, it exposed some serious shortcomings in the world’s public health response.

Those who now describe the pandemic as mild base their conclusion primarily on what, at first, seems like a mortality rate in the United States similar to those seen after seasonal influenza. But my colleagues in developing countries would strongly object.

Though we lack reliable death rates from country to country, certainly no one who helped care for the large number of critically ill patients in Mexico could conclude that the flu in the United States was as severe as in developing countries that lacked our resources.

Here, the vaccine arrived later than estimated, and only about 80 million Americans received it — not nearly enough, but a far higher proportion of the population than in many developing countries. In fact, only 26 of 94 poor countries in need of the protective H1N1 vaccine have even received it so far.

We also cannot count as mild any virus that was so devastating for young adults, along with pregnant women, obese patients and minorities.

Worse yet, this virus made itself particularly hard for clinicians to identify. Whereas doctors associate fever and cough with outbreaks of influenza, one-third of patients admitted to hospitals and up to half of infected outpatients in this pandemic had no fever, yet they were infectious.

And because it is likely that only patients with fever were tested for the presence of the virus, we greatly underestimated the number of people infected. A telling report from Britain showed that when children were tested in cross sectional surveys after the first wave of infection, one in three had antibodies to the virus, meaning that they had been infected — this was 10 times more people than estimated from clinical surveillance.

H1N1 posed huge infection-control problems, especially in hospitals. This was because it was found not only on hard surfaces in the environment, which is common to all influenza strains, but in the stool of patients, a feature of avian influenza.

Public health groups emphasized the necessity of frequent hand-washing, which surely helped reduce transmission. But those groups also disagreed on other preventatives: for instance, the World Health Organization and Society for Health Care Epidemiologists of America recommended the relatively inexpensive surgical mask, whereas the Centers for Disease Control and Prevention argued for the N-95 respirator mask.

In our own country, the virus struck at a time when Americans seemed particularly skeptical about our government and large institutions. The C.D.C. faced an uphill battle to characterize the trajectory of the pandemic, to define its impact, to offer suggestions and to convince a wary public to get vaccinated.

At times, health officials erred in their recommendations. C.D.C. authorities often said that ill children and adults could go back to school or work 24 hours after their fever disappeared — even though young children are contagious for up to three weeks and adults for 5 to 7 days.

It is not an easy task, but our public health authorities need to become clearer about the lexicon of uncertainty — what they know and don’t know about a pandemic. They also need to be transparent about how they devise their recommendations, which often have to balance between infection control and the daily activities of offices and schools. And we need to identify which social distancing techniques truly help control pandemics — for example, does the closing of schools and malls minimize the spread of viruses from infected children to adults?

One year after its appearance, we continue to have many unanswered questions about the virus. Will the novel H1N1 agent become a persistent seasonal virus? Can we produce vaccine more quickly by moving to a cell-based rather than egg-based method? Can we possibly identify the Holy Grail of influenza vaccination, finding a virus target common to all influenza A strains so that we can administer a single vaccination at 10-year intervals?

Even as we work to solve these enigmas, we can try to prepare better for future pandemics. First, we need to approach disease control not as individual nations, but as a global community. In this, Mexico has already set an excellent example. Only 10 days passed between Mexican health authorities’ recognition of a possible new epidemic and their announcement of it, a sharp contrast to the many months in 2003 between the outbreak of SARS in China and its public declaration.

Mexico’s transparency was a policy decision made with full recognition of the unfavorable economic consequences from H1N1, now estimated to have cost almost 1 percent of the gross domestic product. Thanks to that decision, we had an edge in fighting this virus. We should find ways to financially reward early reporting of novel infectious agents, while doing a better job of sharing resources and agreeing on common containment strategies.

Second, we should rely not just on governments for reporting but on the cooperative efforts of international health organizations as well. These groups should set up better sentinel reporting systems in places where new swine or avian variants are most likely to occur — wherever people and pigs or birds live closely together — so that they can identify new virus progeny quickly.

Eventually, we’ll also need to encourage farmers in developing countries to follow agricultural and safety practices that make it less likely that viruses will jump species.

One predicts influenza at his own peril, but it is likely that H1N1 will continue to cause sporadic cases. In some highly susceptible, unvaccinated populations it may even produce local outbreaks.

But the struggle between people and pathogens is a part of life itself. We cannot continue to be surprised every time a new virus emerges. Instead, we must use the lessons we’ve learned during the year since H1N1 arrived to develop more effective public health responses.

CDC says 57 million had H1N1
Washington Times
Joseph Weber
Originally published 04:11 p.m., February 12, 2010, updated 07:56 p.m., February 12, 2010

The federal government said Friday an estimated 57 million people in the U.S. contracted the H1N1 virus -- more than previously thought because early tracking methods accounted for only one in 79 infected.

The Centers for Disease Control and Prevention said the new number is based on statistical models and replaces the earlier method of counting only laboratory-confirmed cases because so many people with the flu do not seek medical care.

"And only a small number of those who do seek care are tested," the agency said.

The method was abandon several months after the outbreak began in spring 2009.

The most recent report -- from April 2009 to mid January -- also estimated 257,000 hospitalizations and 11,690 deaths related to H1N1.

The 57 million cases is roughly 4 percent more than reported in December 2009.

The spread of the virus slowed through summer 2009, then re-emerged in the fall and peaked in October. The subsequent decline follows the arrival of vaccines that were administered at first to only such at-risk patients as babies, pregnant women and people with illnesses.

The report released Friday also states as many as 84 million could have been infected and 17,160 could have died form the virus.

 
H1N1 flu vaccine available today
Westport NEWS
By Pat McCormack
Posted: 11/04/2009 01:01:59 AM EST

Vaccinations against H1N1 flu will be offered today at the Westport/Weston Health Department on Bayberry Lane between 3 and 6 p.m., Mark Cooper, head of the Westport/Weston Health District told the Westport News during an interview Monday.

Monica Wheeler, community health director of the health district, said the vaccinations will be in the form of the nasal spray and via needle inoculations.

As many as 300 doses are expected to be on hand.

Vaccinations are expected to be administered on a first-come, first-served basis, according to Wheeler. She advises potential subjects to come early. That is because vaccine supplies are supposed to top off around 300 doses.

Cooper, meanwhile, reminded residents that persons seeking vaccinations must fit one of the following groups to be eligible to receive vaccinations against H1N1 flu virus.
"¢ Pregnant women may get the injection only.

"¢ All children ages 6 months to 18 years with high-risk medical conditions may receive the injection only.

"¢ Children 2 years to 4 years with no high-risk medical conditions may receive vaccinations via either the nasal spray or injection form.

"¢ 5 years to 18 years with no high risk medical conditions may receive the nasal spray only.

"¢ 2 years to 18 years with high risk medical conditions such as asthma or diabetes may receive the injection vaccine only.

Anyone not listed above and living with or caring for an infant under 6 months may be vaccinated according to the following guidelines:

"¢ If you have underlying medical conditions, you may receive the injection only.

"¢ If you are age 50 or over, you may receive the injection only.

"¢ If you have no high-risk medical conditions and are under 50, you may receive the nasal spray or injections.

Health Director Mark Cooper said in a release: "The Westport/Weston Health District is operating under State of Connecticut Department of Public Health Directives and had no discretion regarding priority groups in setting up the free H1N1 flu vaccination clinic Thursday. If you are not in one of the above groups, you may continue to check our Web site www.wwhd.org/H1N1.htm for further developments."

As more vaccine becomes available, the health district expects to expand eligibility, Cooper noted during the interview. He added, "Eventually, everyone who wants it will be offered vaccine."

Wheeler told the Westport News since darkness will be prevalent toward the end of the free vaccination clinic today, volunteers will be on-hand to see that those vaccinated will be escorted safely into and out of the clinic.

The helpers will be from the Community Emergency Response Team (CERT) and Medical Reserve Volunteer Corps that includes doctors and nurses, as well as trained civilians.

Both Wheeler and Cooper anticipate there is a possibility that many more people will show up than the health district has doses of vaccine for, and both said that the health district will do the best it can and advised folks to be patient.

Cooper recommended patience instead of panic. "Eventually there will be enough vaccine for all who desire to be vaccinated -- if not Thursday, later," he said.

Guilford High School To Close For Two Days Due To Swine Flu
Courant.com
By ARIELLE LEVIN BECKER and ALAINE GRIFFIN
October 24, 2009

Guilford High School has become Connecticut's first public school casualty of the swine flu season this fall, with plans to close Monday and Tuesday.

The move is a precaution after more than 40 percent of the school's students were absent Friday.

"We cannot confirm how many of our students out ill have contracted the H1N1 flu," school officials said in a press release Friday. "However, local health officials believe that, due to the rapid spread of symptoms and the known presence of influenza A (H1N1), the majority of these students likely have the virus."

Unlike in the spring, when state officials urged schools to consider closing if they had a probable case of swine flu, state and federal guidelines now encourage school districts to stay open when possible.

But state Department of Education spokesman Tom Murphy said closing may make sense when a significant number of students have fallen ill or there are not enough teachers to carry on work in the classrooms.

In Guilford, 42 percent of the more than 1,100 students in the school were absent Friday, according to the district's press release.

Connecticut has not had the widespread flu activity most other states have seen this fall, but that could change. One indicator, the percentage of emergency room visits attributed to flu-like illnesses, has been increasing statewide since Oct. 4.

"We're starting to see increased activity, which is not unexpected," said William Gerrish, a spokesman for the state Department of Public Health.

Murphy said Guilford's is the only school district so far to give the state formal word of extensive H1N1 exposure, Murphy said.

Guilford's six other schools will be open next week, but extracurricular activities outside the normal school day are canceled at all schools.

"By closing the high school on Monday and Tuesday and canceling all activities before and after school, we can provide an uninterrupted four-day recovery period and significantly deter the transmission of the virus to additional students and staff," the district's statement said.

Flu On Campuses

Flu cases have been showing up on some college and university campuses in the state this fall as well. Most schools are following state and federal guidelines and treating students with flu-like symptoms as if they have swine flu, rather than testing to confirm. Many are advising students who live within driving distance to go home to recover.

As of Friday, 51 students at Trinity College in Hartford were exhibiting flu-like symptoms. Eighteen were isolated in their residence halls and 33 were at home or elsewhere off campus, spokeswoman Michele Jacklin said. So far this school year, 52 Trinity students have had flu-like illnesses and recovered.

Wesleyan University in Middletown had 28 students with flu-like symptoms Thursday. Eight went home and 20 were isolated in their rooms. An average of six students a day have had flu-like illnesses this month, according to the university. Two students developed pneumonia, but there were no other complications or hospitalizations.

The University of Hartford had about a dozen cases confirmed as swine flu since Oct. 12, spokesman David Isgur said. The school's health department has contracted with an outside lab that has been testing and confirming H1N1. None of the students has required more than the typical treatment for flu, Isgur said.

The number of cases represents a small fraction of the campus of more than 4,800 students, but Isgur said the presence of swine flu has been raising students' awareness about the importance of precautions against flu.

"It's reminding everybody to stay pretty vigilant because we're just getting to the beginning of real flu season," Isgur said.

Other schools have also seen little flu activity.

At St. Joseph College in West Hartford, about 10 students have gone home since the beginning of the year because of flu-like illnesses, spokeswoman Cynthia Mariani said.

Western Connecticut State University in Danbury had 10 to 15 cases that may have been swine flu, spokesman Paul Steinmetz said.

Eastern Connecticut State University in Willimantic had seven cases of flu-like illness in the past 3½ weeks, spokesman Edward Osborn said, and six students at Southern Connecticut State University in New Haven went home as a precaution after reporting flu-like symptoms.

"Our policy has been the best treatment is for you to go home and be treated by your own family physician," spokes- man Patrick Dilger said.

UConn's student health services director, Michael Kurland, could not be reached Friday for current flu statistics at the university.

'Relocation Housing'

For students who don't live close enough to go home, schools are making various plans. Wesleyan designated unoccupied housing as "flu relocation housing," where up to 40 students with flu could go to stay isolated. Trinity established a buddy system and made food available to students who are isolated in their dorms. The University of Hartford's dining services developed a "takeout" system to allow students to bring the meal card of a sick student to the cafeteria and carry out food. In New Haven, Yale University students with sick roommates have been moved to other rooms on campus.

At Yale, the flu cases came early in the school year, peaking at the end of last month, said Dr. Paul Genecin, director of university health services. At the time, Yale's health services was seeing 20 to 30 students a day with flu-like symptoms. All were mild or moderate, and none required hospitalization.

"That's really quieted down considerably," Genecin said.

More recently, Yale health services, which includes faculty, staff and their families, has been seeing more cases among children. Genecin said children may be the next surge group for the flu.

"We're fortunate up to this point that we're mostly seeing mild illness," Genecin said. "But I think that it's important not to be complacent about this epidemic and to say, 'Well it's all much ado about nothing,' because the spectrum of influenza is broad and there are people who are suffering from a severe illness which can lead to respiratory failure and death in rare cases. So I think it's very important for public health people to be very aware of that and not to minimize the potential impact of this flu."

Copyright © 2009, The Hartford Courant

ASK THE WESTPORT-WESTON HEALTH DISTRICT - click here.
Where to Get a Flu Shot Is Big Worry of Season
NYTIMES
By SUSAN SAULNY
October 12, 2009

CHICAGO — In Alabama, Minnesota and Ohio, health care and emergency medical service workers have been given priority for swine flu immunization. Here in Illinois, and in parts of California and Indiana, young children and their families are first in line.

And across the country, state and local health hot lines are jammed and message boards are lighting up with one question: When can I get my vaccination?

As a small fraction — some 2.4 million doses — of the nasal spray version of the new swine flu vaccine began arriving last week at local health departments, plans for limited distribution were being formulated on the fly or dusted off from earlier in the decade, when fears of an avian flu pandemic sparked a rush of emergency preparedness.

“We are getting our fair share, but I think everybody feels they’re not getting it fast enough,” Lynn Corliss, a public health nurse in Siskiyou County, Calif., said of the vaccine.

In Monroe County, Ind., health officials said their biggest problem was not having enough staff to administer the vaccine. At schools, they are sending notices home with children to ask for parent volunteers.

“It’s going as well as could be expected,” said Penny Caudill, the administrator of the Monroe County Health Department. “It’s a huge undertaking. It’s so new, and everything you do is a bit of trial and error.”

In large part, chaos seems to have been averted, at least initially. Many people seem to be more eager to receive the injectable form of the vaccine, which is not yet available. And the nasal spray, called FluMist, has some limits on who may use it. It is not recommended for infants, the elderly or pregnant women.

Still, health officials were struggling to communicate that information to the public and make the general population aware that the first doses were not being widely distributed. So for most people, there was nothing to do but wait.

“The public has legitimate questions,” said Jim McVay, director of public health promotion and chronic disease at the Alabama Department of Public Health. “They call us. They call the doctor. They say, ‘I saw it on the news. It’s available. Why don’t you have it?’ We’re trying to explain that yes, we will have ample supply, and yes, we’d like to have it now. But there is a problem of having to ship out the largest outreach of immunization in our nation’s history in the shortest time period.”

The Centers for Disease Control and Prevention has embarked on an extensive immunization drive, and, by later in the flu season, there will be enough vaccine for the general population. But, to date, the 50 states have received only part of the available stock based on their populations. At the moment, demand is far outstripping supply — and patience.

State health departments were, for the most part, distributing FluMist to counties in proportions based on their population sizes. Counties were turning the vaccine over to population centers, schools and hospitals as requests came in, and according to recommendations from the C.D.C.

In Iowa, the state and county health departments are using plans developed in 2003 after the emergence of the bird flu in Asia.

“This is something we’ve been thinking about for years, since the H5N1 avian flu: what would it really take if we had to move at the level of hundreds of thousand of doses as opposed to tens of thousands?” said Rick Kozin, program manager at the Polk County Health Department. “The plan is a product of a lot of partnership building that’s taken place over the last several years.”

The thinking was much the same in Ohio.

“We were fully aware that there were three pandemics in the 20th century,” said Kristopher Weiss, a spokesman for the Ohio Department of Health, which is relying on guidelines developed around avian flu fears. Of the need to put an emergency plan in place, he said, officials knew it was “only a matter of time.”

Ohio received 61,500 doses of the vaccine on Thursday, and more than 100 local health departments began receiving allotments on Friday. Health care workers took priority.

Gov. Ted Strickland, a Democrat, signed an executive order last week to allow 17,000 emergency medical technicians to provide the vaccine if needed. The State Health Department posts updates about the vaccine on its Web site and has set up a toll-free number for Ohioans with questions about the H1N1 virus.

“I think it’s going relatively well,” Mr. Strickland said.

In Arkansas, officials have been aided by a coincidence: last year the legislature granted $2.9 million for vaccinating students against the seasonal flu. Ed Barham, a spokesman for the Arkansas Department of Health, said that plan created an infrastructure on which the department could piggyback and distribute swine flu vaccines at the same time.

Vaccinations are scheduled to start on Wednesday in Little Rock. In the meantime, Arkansas health officials will give the vaccine to the neediest cases: health workers, children and those with other health conditions.

“It’s very much shooting at a moving target,” Mr. Barham said.

In southwest Utah, the area’s Public Health Department divided its allotment of the swine flu vaccine among the five county hospitals, based on the size of the medical center and its community.

Even though the department had distribution plans in place, it has had to be nimble.

“Probably about three weeks ago we heard that our first batches would be nasal spray, and we were expecting injections,” said David Heaton, public information officer for the Southwest Utah Public Health Department. “We were going to target pregnant women.”

Plans changed.

“We realized this would be more of a matching game than simply getting people in,” Mr. Heaton said.

When enough doses do become available for the general public, officials have plans in place to open drive-through vaccination clinics they call “shootouts.”

The clinics were first planned in preparation for the avian flu.

“The swine flu caught us off guard last April, but we’ve drilled them and done them so now we can do that successfully with the H1N1 vaccine as it comes in,” he said of the clinics. “We’re geared up and ready to go.”
U.S., other nations stop counting pandemic flu cases
YAHOO
By MIKE STOBBE, AP Medical Writer
Fri Oct 9, 4:48 pm ET

ATLANTA – U.S. health officials have lost track of how many illnesses and deaths have been caused by the first global flu epidemic in 40 years.

And they did it on purpose.

Government doctors stopped counting swine flu cases in July, when they estimated more than 1 million were infected in this country. The number of deaths has been sitting at more than 600 since early September. Health officials had previously counted lab-confirmed cases, though the tally was skewed because many people who got sick never were tested.

Other nations have stopped relying on lab-confirmed cases, too, and health officials say the current monitoring system is adequate. But not having specific, accurate counts of swine flu means the government doesn't have a clear picture of how hard the infection is hitting some groups of people, said Andrew Pekosz, a flu expert at Johns Hopkins University.

The novel H1N1 flu seems to be more dangerous for children, young adults, pregnant women and even the obese, according to studies based on small numbers of patients. And federal health officials are keeping track of children's deaths. But exactly how much more at risk kids and other groups are is hard to gauge if the overall numbers are fuzzy.

"This wasn't as critical early on, when case numbers were low," said Pekosz. But now, it's hard to say exactly how swine flu's dangers vary from group to group, he said.

The Centers for Disease Control and Prevention is relying on a patchwork system of gathering death and hospitalization numbers. Some states are reporting lab-confirmed cases. Others report illnesses that could be the new swine flu, seasonal flu or some other respiratory disease.

Some say that's a more sensible approach than only counting lab-confirmed cases. Many people who got sick never get tested, so the tally of swine flu cases was off almost from the very beginning, they say.

"It was a vast underestimate," said Dr. Zack Moore, a respiratory disease expert for the North Carolina Department of Health and Human Services.

What's more, as the initial panic of the new virus ebbed, fewer people were fully tested, so the results weren't as accurate or comprehensive. "The kinds of numbers you were getting later in the summer were different from the numbers early on," said Dr. Daniel Jernigan, deputy director of the CDC's influenza division.

That's why the CDC shifted to counting the new flu like it counts seasonal flu cases, agency officials said. "We're concerned folks are focused on the numbers and missing that influenza is monitored by looking at trends," Jernigan said.

It's likely that millions of Americans have been sickened by swine flu by now, CDC officials say. New York City alone estimates it had roughly 1 million cases since swine flu first hit last spring.

While everyone would like an exact measure of how every disease is affecting society, that simply doesn't exist. "We don't even have a good measure of how many heart attacks there are every day," which would seem like a relatively easy thing to track, noted Marc Lipsitch, a Harvard University professor of epidemiology.

More comprehensive tracking is not possible with current resources and medical record-keeping, some public health advocates say.

"The fact that it is a challenge to come up with these data proves that we have underdeveloped surveillance systems in this country," said Jeff Levi, executive director of Trust for America's Health, a Washington-based public health research organization.

Most disease investigation and case-counting is done by state and local health departments. But quality varies state to state, and in many places it may be getting worse: State budget shortfalls and other problems led to the elimination of 7,000 health department jobs last year and 8,000 more jobs in the first six months of this year.

"You take for granted this work goes on. But it is difficult to take for granted any longer, with these cuts going on," said Robert Pestronk, executive director of the National Association of County and City Health Officials.

However, Pestronk and others think the government's current system of flu tracking is adequate and getting better.

The CDC has nine ways of monitoring influenza. Some focus on people who die from flu-like illness — one tracking deaths of children, another counting pneumonia and flu deaths of all ages in 122 cities.

Other systems gather flu-testing information from labs across the country. And some rely on reports of flu-like illness from hospital emergency departments and from estimates from state and territorial health officials.

Those systems combine to give a good general picture of whether more or fewer people are going to the doctor with flu, and how often lab samples are showing swine flu as compared to other respiratory bugs, health officials say.

There are problems that make even that data incomplete or inaccurate. Rapid flu tests — which are used in counting hospitalizations — are often wrong when they indicate a patient doesn't have swine flu, CDC studies have shown. In some cases, flu or swine flu was only confirmed at autopsy. But most deaths are not autopsied.

These problems are not unique to the United States. The World Health Organization also stopped counting cases in July, after deciding that tracking individual swine flu cases was too overwhelming for countries where the virus was spreading widely. The WHO has continued to update swine flu reports, but with the disclaimer that since countries are no longer required to test and report cases, WHO's numbers underestimate.

Britain also releases weekly swine flu updates, but the numbers are estimates based on how many people go to their doctors with flu-like illness, as well as calls logged to the national flu service.

Despite resource limitations and data imperfections, experts say the U.S. system is good enough to alert the experts when major changes occur in the pandemic.

"There will always be an error factor, misdiagnosis, misclassifications," said Pestronk, formerly the head of a county health department in Michigan. "We'll never be at 100 percent of people getting tested. The question is what's good enough for purposes of planning and acting on the burden of disease."

Avian flu has an antidote - NYTIMES suggests it might be used in the event of a "Swine Flu" ourbreak.

Editorial:  Preparing for the Swine Flu
NYTIMES
September 1, 2009

There was a lot of confusion last week about swine flu. A presidential advisory group issued a “plausible scenario” in which a swine flu epidemic could cause up to 90,000 deaths, three times the mortality in a typical flu season. The Centers for Disease Control and Prevention countered that the toll would most likely not approach that number.

Our own take is this: A swine flu epidemic this fall and winter is likely to infect more people than a normal flu, but the virus will not be abnormally lethal. If it spreads rapidly after schools open, we will have to face it without vaccine, which will not arrive in substantial quantities until the swine flu epidemic has peaked.

The report that sparked concern was issued by the President’s Council of Advisors on Science and Technology. The council stressed that it was not predicting what would happen but was simply offering a scenario to help the government develop responses to a potential epidemic.

The report posited an epidemic that could produce symptoms in 60 million to 120 million people and cause as many as 90 million to seek medical attention; up to 1.8 million could be hospitalized, 300,000 could flood into crowded I.C.U.’s, and 30,000 to 90,000 people could die.

Even some members of the advisory panel think their estimates may be a bit high. In any case, this is a virus that is no more lethal, and possibly less lethal, than normal flu strains.

In the initial outbreaks last spring, an estimated 800,000 New Yorkers, 10 percent of the city’s population, developed symptoms attributed to the swine flu virus. Only 54 died — an encouragingly low death rate. Most infected people got better without medical treatment.

Another encouraging sign is that the virus has not become more virulent as it wends its way around the world. Finally, the United States is better prepared than ever before. The Bush administration and Congress invested heavily in planning and in stockpiling medicines and medical supplies to fight a feared avian flu pandemic that never materialized, and the Obama administration has continued the effort. The same medicines should work against the swine flu virus.

The rub is that a vaccine to prevent swine flu is still being tested and will not be ready until mid-October, too late to help most people if the virus spreads rapidly in September after schools and colleges open almost everywhere. The standard advice will be to cover our coughs, wash our hands, and stay home if sick. There will be medicines to treat the very sick.

The swine flu virus seems to infect mostly people under age 65, in contrast with seasonal flus that primarily harm the elderly. Health officials are assuming that they have to prepare for both kinds of flu to be circulating and will be offering vaccines to protect against both. Whatever damage swine flu causes may well be piled on top of the normal flu sickness and deaths.


WWHD announces joint local task force to plan for influenza outbreaks

(Aug. 24, 2009) Mark A.R. Cooper, Director of Health for the Westport Weston Health District has announced that school, government and public health officials are collaborating through a joint local task force to plan for and take action related to H1N1 influenza outbreaks during the coming flu season. “We are working together to do all that is possible to prepare for the uncertain flu season ahead of us and to make sure our citizens understand how best to minimize the spread of influenza in our schools and communities”.

Cooper praised school nursing, local school and government officials for their participation and efforts to safeguard students and citizens.

Cooper said that the three main goals of the Task Force are to:

  1. balance the risk of flu within our schools and community with the disruption that school dismissals will cause in education and the wider community;
  2. facilitate collaboration at the local level; and,
  3. enhance communication related to H1N1 influenza among local, state and national health and education officials and to prevent the spread of flu and other communicable diseases within our schools and community.

The towns of Westport, Weston and Wilton have reviewed and are prepared to implement their Public Health Preparedness and Response Plan should the severity of the H1N1 flu increase in the coming weeks or months.

Noting the concern about the availability of a vaccine that is currently under production and testing by federal authorities, Cooper indicated the federal Center for Disease Control and Prevention (CDC) continues to anticipate that an H1N1 vaccine should be licensed and ready for distribution by mid-fall 2009. The vaccine will be available at a number of sites including local physician offices, health clinics and the our 2009 flu clinics. Once available, those administering the vaccine will be held accountable to follow CDC established priorities and protocols. The CDC has stated the priorities and protocols will be enforced by federal, state and local authorities.   

Additional information is available at the following websites.

http://www.cdc.gov/h1n1flu/

www.ct.gov/ctfluwatch

-------------------

Novel H1N1 Vaccination Recommendations (July 30, 2009)
http://www.cdc.gov/h1n1flu/vaccination/acip.htm

With the new H1N1 virus continuing to cause illness, hospitalizations and deaths in the US during the normally flu-free summer months and some uncertainty about what the upcoming flu season might bring, CDC's Advisory Committee on Immunization Practices has taken an important step in preparations for a voluntary novel H1N1 vaccination effort to counter a possibly severe upcoming flu season. On July 29, ACIP met to consider who should receive novel H1N1 vaccine when it becomes available.

Novel H1N1 Vaccine

Every flu season has the potential to cause a lot of illness, doctor’s visits, hospitalizations and deaths.  CDC is concerned that the new H1N1 flu virus could result in a particularly severe flu season this year.  Vaccines are the best tool we have to prevent influenza.  CDC hopes that people will start to go out and get vaccinated against seasonal influenza as soon as vaccines become available at their doctor’s offices and in their communities (this may be as early as August for some).  The seasonal flu vaccine is unlikely to provide protection against novel H1N1 influenza.  However a novel H1N1 vaccine is currently in production and may be ready for the public in the fall. The novel H1N1 vaccine is not intended to replace the seasonal flu vaccine – it is intended to be used along-side seasonal flu vaccine.

CDC’s Advisory Committee on Immunization Practices (ACIP), a panel made up of medical and public health experts, met July 29, 2009, to make recommendations on who should receive the new H1N1 vaccine when it becomes available.  While some issues are still unknown, such as how severe the virus will be during the fall and winter months, the ACIP considered several factors, including current disease patterns, populations most at-risk for severe illness based on current trends in illness, hospitalizations and deaths, how much vaccine is expected to be available, and the timing of vaccine availability.

The groups recommended to receive the novel H1N1 influenza vaccine include:

    * Pregnant women because they are at higher risk of complications and can potentially provide protection to infants who cannot be vaccinated;
    * Household contacts and caregivers for children younger than 6 months of age because younger infants are at higher risk of influenza-related complications and cannot be vaccinated. Vaccination of those in close contact with infants less than 6 months old might help protect infants by “cocooning” them from the virus;
    * Healthcare and emergency medical services personnel because infections among healthcare workers have been reported and this can be a potential source of infection for vulnerable patients. Also, increased absenteeism in this population could reduce healthcare system capacity;
    * All people from 6 months through 24 years of age
          o Children from 6 months through 18 years of age because we have seen many cases of novel H1N1 influenza in children and they are in close contact with each other in school and day care settings, which increases the likelihood of disease spread, and
          o Young adults 19 through 24 years of age because we have seen many cases of novel H1N1 influenza in these healthy young adults and they often live, work, and study in close proximity, and they are a frequently mobile population; and,
    * Persons aged 25 through 64 years who have health conditions associated with higher risk of medical complications from influenza.

We do not expect that there will be a shortage of novel H1N1 vaccine, but flu vaccine availability and demand can be unpredictable and there is some possibility that initially, the vaccine will be available in limited quantities.  So, the ACIP also made recommendations regarding which people within the groups listed above should be prioritized if the vaccine is initially available in extremely limited quantities. For more information see the CDC press release CDC Advisors Make Recommendations for Use of Vaccine Against Novel H1N1. 

Once the demand for vaccine for the prioritized groups has been met at the local level, programs and providers should also begin vaccinating everyone from the ages of 25 through 64 years. Current studies indicate that the risk for infection among persons age 65 or older is less than the risk for younger age groups. However, once vaccine demand among younger age groups has been met, programs and providers should offer vaccination to people 65 or older.
CDC, States: US Swine Flu Cases Jump to 68
NYTIMES
By THE ASSOCIATED PRESS
Filed at 2:03 p.m. ET
April 28, 2009

ATLANTA (AP) -- The number of confirmed swine flu cases in the United States has jumped to 64, federal officials said Tuesday, and states reported at least four more.

The U.S. Centers for Disease Control and Prevention said the new count includes ''a number of hospitalizations.'' CDC officials had previously said just one person had been hospitalized.

The CDC said there were 17 new cases in New York City, four more in Texas and three additional cases in California. That brings the total numbers of cases confirmed by federal officials to 45 in New York City, 10 in California, six in Texas, two in Kansas and one in Ohio.

State health officials in California have confirmed three other cases, and Indiana authorities have confirmed one.

The increase is not surprising. For days, CDC officials have said they expected to see more confirmed cases -- and more severe illnesses. Health officials across the country have stepped up efforts to look for cases, especially among people with flu-like illness who had traveled to Mexico.

CDC officials also warned that updates in the number of confirmed cases would at time be disjointed, as different states announce new information before the CDC's national count is updated.

MEXICO CITY


AP: Mexico's epidemiology boss faults WHO 
DAY
By ANDREW O. SELSKY, Associated Press Writer 
Posted on May 1, 9:39 AM EDT

MEXICO CITY (AP) -- A top Mexican medical officer accused the World Health Organization of being slow to respond to the country's warning about a health crisis that turned into a global swine flu scare. The WHO disputed the claim.

Dr. Miguel Angel Lezana, Mexico's chief epidemiologist, told The Associated Press late Thursday his center alerted the Pan American Health Organization, a regional arm of WHO, on April 16 about an unusually late rash of flu and pneumonia cases in Mexico.  But he said no action was taken until eight days later, when the WHO announced it was worried the outbreak could become a pandemic.

"It seems it should have been more immediate," Lezana, director of the National Epidemiology Center, told AP in a telephone interview. He called for an investigation into WHO's handling of the crisis.

WHO officials said Friday the agency learned April 9 of cases of "suspicious influenza" from Mexico and responded quickly on April 24 when U.S. and Canadian laboratories identified the virus as a new strain of flu.

"We moved into operation within a matter of hours," WHO spokesman Thomas Abraham told reporters.

Mexican health authorities came under criticism, particularly from frustrated citizens, for a slow and bumbling early response to the outbreak.  Hong Kong's leader said Friday the territory has a confirmed case of swine flu, Asia's first. In the United States, the confirmed case count stood at 132, and state laboratories believe the numbers are even higher. Hundreds of U.S. schools were closed Thursday.  In Mexico, the outbreak's epicenter, new cases and the death rate were leveling off, the country's top medical officer said. Health authorities said they have confirmed 300 swine flu cases and 12 deaths due to the virus.

"The fact that we have a stabilization in the daily numbers, even a drop, makes us optimistic," Mexican Health Secretary Jose Angel Cordova said. "Because what we'd expect is geometric or exponential growth. And that hasn't been the situation."

The only confirmed swine flu death outside Mexico was a Mexican toddler who died in a Texas hospital Monday.  The United States is buying 13 million courses of anti-flu drugs to replenish its stockpile and sending 400,000 courses to Mexico. U.S. health officials say a swine flu vaccine could not be ready until fall at the earliest.  Mexico shut down all but essential government services and private businesses Friday, the start of a five-day shutdown that includes a holiday weekend. Schools are also closed through Tuesday.

Mexico City's notoriously clogged avenues were clear, crime was down and the smog dropped to levels normally seen only on holidays. Mexico is using the shutdown to determine whether to extend or ease emergency measures.  Lezana, the chief epidemiologist, said his department was alarmed by flu and pneumonia cases in Mexico earlier in April and notified the local office of PAHO by e-mail, following international protocol.

He said the illnesses raised a red flag because the flu was occurring at least a month after flu season normally ends in Mexico.  Four days later, PAHO still had not responded, so the National Epidemiology Center asked PAHO whether it needed more, Lezana said. He said PAHO responded the alert was being handled.  Lezana said that as far as he knew, the PAHO regional office in Washington and WHO took no action until April 24, when WHO announced an epidemic was under way.

Lezana had learned just the day before, from a testing of a sample that Mexico sent to a lab in Canada, that people were coming down with a new, mutated and lethal swine flu virus. By then, more than 1,000 people had been sickened in Mexico.

Daniel Epstein, a PAHO spokesman in Washington, told The Washington Post the agency received a message from Mexican authorities April 16 about an unusual outbreak. He described a system that sends messages to WHO headquarters in Geneva automatically.  WHO officials in Geneva confirmed Friday that the organization had received reports from Mexico of cases of suspicious influenza and that the organization reacted quickly when the new flu virus was identified on April 24.

WHO chief Dr. Margaret Chan was aboard a flight to the United States at the time but was briefed immediately when she landed, Abraham said. She canceled her appointments, met with U.S. and Mexican authorities and flew back to Geneva on April 25. That evening, WHO told the world it faced a possible flu pandemic.

"I think that is a pretty rapid response," Abraham said.

WHO flu chief Dr. Keiji Fukuda, speaking before the Mexican epidemiologist issued his criticism, told reporters late Thursday there is always some delay when unusual illnesses are detected, particularly during flu season.

"Most diseases do not come out with people walking around with 'new disease' written on their forehead and 'we need to call an international response,'" he said. "And in this case the countries which were affected earlier, they really were communicating in a very appropriate way."

While Mexico waited for WHO to help, Lezana said, Mexican authorities tried to identify the outbreak and stop it. Mexican medical teams interviewed 472 people who may have come into contact with the first known swine flu fatality, a 39-year-old woman.  But only 18 of the 472, all hospital workers, were tested for swine flu. And in other parts of Mexico, health workers only this week started visiting the families of victims to find out whether they contracted it as well.

The Red Cross said it was readying an army of 60 million volunteers who could be deployed around the world to help slow the virus' spread. Besides the U.S. and Mexico, nine nations have confirmed cases, most in Europe.
WHO again raises swine flu alert 
DAY
By Denise Grady 
Published on 4/30/2009

The global spread of swine flu, a pandemic, is highly likely, the World Health Organization said on Wednesday as it raised its alert level to Phase 5, the next-to-highest level in the worldwide warning system.
Phase 5 has never been declared before. Phase 6 means a pandemic is under way. WHO said its decision was based on the continuing spread of swine flu in the United States and Mexico, particularly the increasing numbers of unexplained cases among people not exposed to travelers or to institutions like schools or hospitals where many people have close contact with one another and high rates of transmission might be expected.

”All countries should immediately activate their pandemic preparedness plans,” Dr. Margaret Chan, director-general of the organization, said at a news conference in Geneva. “Countries should remain on high alert for unusual outbreaks of influenza-like illness and severe pneumonia.”

The first death from swine flu in the United States - of a 22-month-old child from Mexico who was being treated in Houston - was reported on Wednesday, along with more infections and hospitalizations. The U.S. Centers for Disease Control and Prevention reported 91 confirmed cases from 10 states, up from 64 cases in five states on Tuesday.

Chan emphasized the need for calm, but at times spoke as if a pandemic had already begun, saying, for instance, “WHO will be tracking the pandemic.” She also emphasized that flu epidemics tended to take much higher death tolls in poor countries than in rich ones, and said her organization and others would need to make special efforts to help poorer nations.

She called for global solidarity, saying, “After all, it really is all of humanity that is under threat during a pandemic.”

Presidential advice

President Barack Obama, terming the outbreak “cause for deep concern but not panic,” took the unusual step of using a prime time televised news conference, convened to mark his 100th day in office, to deliver a public health message to the American people.

”Wash your hands when you shake hands, cover your mouth when you cough,” he said from the East Room of the White House. “It sounds trivial, but it makes a huge difference. If you are sick, stay home. If your child is sick, take him out of school.”

With public health officials recommending that schools close if there are more confirmed or suspected cases, Obama urged parents and businesses to “think about contingency plans” in the case of such closings. He said he was calling on Congress to authorize an immediate $1.5 billion to “support our ability to monitor and track this virus” and to build the supply of antiviral drugs.

Government preparedness plans may include steps like ensuring that laboratories can test for the disease and that health systems can identify and treat cases, track an outbreak and prevent the virus from spreading in hospitals and clinics. Governments should also decide on measures like closing schools and discouraging or banning public gatherings. Mexico, for instance, has prohibited people from eating in restaurants and is allowing restaurants to provide only take-out food.

”The more recent illnesses and the reported death suggest that a pattern of more severe illness associated with this virus may be emerging in the U.S.,” the CDC said on its Web site. More hospitalizations and deaths are expected, the site said, because the virus is new and most people have no immunity to it.

The outbreak has caused such concern because officials have never seen this particular strain of the flu passing among humans before, said Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases. “There is no background immunity in the population, and it is spreading from human to human - all of which has the potential for a pandemic,” Fauci said.

Dr. Richard Besser, acting director of the CDC, said officials have no way of predicting whether the outbreak will become more serious.

”You don't know if this is a virus that will fizzle in a couple of weeks or one that will become more or less virulent or severe in the diseases it causes,” Besser said. He added that officials must follow government plans for a pandemic because of that unpredictability.

The CDC's count of 91 confirmed cases in the United States did not include later reports by Maine and Nevada of confirmed cases there, which were announced after the CDC tally had been posted. In addition, there were suspected cases in Louisiana and Delaware. Kits being provided to the states and other countries will allow them to test for the virus on their own and obtain results within a few hours.

New York City added five new confirmed cases, bringing its total to 49. All have links to Mexico or St. Francis Preparatory School in Queens, where the virus first surfaced in New York, health officials said. The city identified five more probable cases.

The total in Canada rose from 16 to 19. In Mexico, more than 150 people are suspected to have died from the illness, and almost 2,500 are thought to have been infected.

Numbers rising

Kathleen Sebelius focused on the outbreak on Wednesday during her first news conference as the secretary of Health and Human Services. “We're determined to fight this outbreak and do everything we can to protect the health of every American,” she said.

Sebelius noted that the CDC had recommended that schools close only if a student is found to be infected with the swine flu virus. More aggressive steps are under discussion, she said, but officials realize that school closings can cause problems for families.

”What happens to parents? Where do children go?” she asked.

Besser, who joined the news conference via a video feed, said the most recent cases included patients of a broad range of ages, with two-thirds of all cases occurring in people under the age of 18.

”There have been five hospitalizations so far, including the child who died. But we have a number of suspect cases that have been hospitalized and we expect that number to go up,” Besser said. “It's a serious outbreak, and we're taking aggressive measures.”

Besser said that a quarter of the nation's stockpile of 50 million treatments of antiviral medicines would be distributed to states by Sunday.

The United States has no plans to close international borders because, Besser said, such closings are not effective in slowing pandemics. When Hong Kong was hit with severe acute respiratory syndrome, or SARS, “increased border screening on entry and exit was not an effective way of identifying cases or preventing transmission,” Besser said.

Nonetheless, Customs and Border Protection agents have stepped up efforts to spot sick travelers and are passing out travel health advisories.

”Individuals who are identified as sick are referred to public health professionals for evaluation,” Besser said.

Some elected officials have begun to question the decision to leave the borders open. Homeland Security Secretary Janet Napolitano was grilled on Wednesday by senators who asked whether her agency was acting aggressively enough to stop the virus from spreading from Mexico into the United States. The senators, including John McCain, R-Ariz., and Joe Lieberman, D-Conn., asked several times why the Obama administration had decided against closing the border and banning travel to Mexico.

Sen. Susan Collins, R-Maine, took issue with Napolitano's decision to use only “passive inspection techniques” to monitor people entering the United States. She urged that customs officials inspect more thoroughly and that the agency consider using heat sensors that allow agents to detect fevers among travelers entering the country.  



Presumably, these birds are giving samples to be tested for H7N9...

China reports new bird flu case in Hunan province
Reuters
27 April 2013

BEIJING (Reuters) - China on Saturday reported its first case of H7N9 bird flu in the southern province of Hunan, the latest sign the virus that has killed 23 people in the country is continuing to spread.

The official Xinhua news agency said the patient was a 64-year-old woman from Shaoyang city who developed a fever on April 14, four days after having contact with poultry. Her condition had improved with treatment, it added.

The flu was first detected in March. This week, the World Health Organization called the virus "one of the most lethal", and said it is more easily transmitted than an earlier strain that has killed hundreds around the world since 2003.

None of the 41 people who had come into contact with the newly-confirmed Hunan patient, identified only by the surname Guan, had shown symptoms, Xinhua said.

A 54-year-old man who fell ill in Jiangxi province was also being treated in Hunan, where he was diagnosed with H7N9, Xinhua said.

The Hunan cases come a day after the eastern province of Fujian reported its first case and during the same week that a man in Taiwan become the first case of the flu outside mainland China. He caught the flu while travelling in China.

Chinese scientists confirmed on Thursday that chickens had transmitted the flu to humans.

(Reporting by John Ruwitch; Editing by Jeremy Laurence)
OTHER FLU OUTBREAKS:

http://news.bbc.co.uk/1/hi/in_depth/world/2005/bird_flu/default.stm


http://news.bbc.co.uk/2/hi/europe/4723688.stm


Something lurking beneath the ripples on this man-made lake on the Colorado River.

6 die from brain-eating amoeba in lakes
By CHRIS KAHN, Associated Press Writer
Sat Sep 29, 12:59 AM ET

PHOENIX - It sounds like science fiction but it's true: A killer amoeba living in lakes enters the body through the nose and attacks the brain where it feeds until you die.  Even though encounters with the microscopic bug are extraordinarily rare, it's killed six boys and young men this year. The spike in cases has health officials concerned, and they are predicting more cases in the future.

"This is definitely something we need to track," said Michael Beach, a specialist in recreational waterborne illnesses for the Centers for Disease Control and Prevention.

"This is a heat-loving amoeba. As water temperatures go up, it does better," Beach said. "In future decades, as temperatures rise, we'd expect to see more cases."

According to the CDC, the amoeba called Naegleria fowleri (nuh-GLEER-ee-uh FOWL'-erh-eye) killed 23 people in the United States, from 1995 to 2004. This year health officials noticed a spike with six cases — three in Florida, two in Texas and one in Arizona. The CDC knows of only several hundred cases worldwide since its discovery in Australia in the 1960s.

In Arizona, David Evans said nobody knew his son, Aaron, was infected with the amoeba until after the 14-year-old died on Sept. 17. At first, the teen seemed to be suffering from nothing more than a headache.

"We didn't know," Evans said. "And here I am: I come home and I'm burying him."

After doing more tests, doctors said Aaron probably picked up the amoeba a week before while swimming in the balmy shallows of Lake Havasu, a popular man-made lake on the Colorado River between Arizona and California.  Though infections tend to be found in southern states, Naegleria lives almost everywhere in lakes, hot springs, even dirty swimming pools, grazing off algae and bacteria in the sediment.

Beach said people become infected when they wade through shallow water and stir up the bottom. If someone allows water to shoot up the nose — say, by doing a somersault in chest-deep water — the amoeba can latch onto the olfactory nerve.  The amoeba destroys tissue as it makes its way up into the brain, where it continues the damage, "basically feeding on the brain cells," Beach said.

People who are infected tend to complain of a stiff neck, headaches and fevers. In the later stages, they'll show signs of brain damage such as hallucinations and behavioral changes, he said.  Once infected, most people have little chance of survival. Some drugs have stopped the amoeba in lab experiments, but people who have been attacked rarely survive, Beach said.

"Usually, from initial exposure it's fatal within two weeks," he said.

Researchers still have much to learn about Naegleria. They don't know why, for example, children are more likely to be infected, and boys are more often victims than girls.

"Boys tend to have more boisterous activities (in water), but we're not clear," Beach said.

In central Florida, authorities started an amoeba phone hot line advising people to avoid warm, standing water and areas with algae blooms. Texas health officials also have issued warnings.  People "seem to think that everything can be made safe, including any river, any creek, but that's just not the case," said Doug McBride, a spokesman for the Texas Department of State Health Services.

Officials in the town of Lake Havasu City are discussing whether to take action. "Some folks think we should be putting up signs. Some people think we should close the lake," city spokesman Charlie Cassens said.

Beach cautioned that people shouldn't panic about the dangers of the brain-eating bug. Cases are still extremely rare considering the number of people swimming in lakes. The easiest way to prevent infection, Beach said, is to use nose clips when swimming or diving in fresh water.

"You'd have to have water going way up in your nose to begin with" to be infected, he said.

David Evans has tried to learn as much as possible about the amoeba over the past month. But it still doesn't make much sense to him. His family had gone to Lake Havasu countless times. Have people always been in danger? Did city officials know about the amoeba? Can they do anything to kill them off?

Evans lives within eyesight of the lake. Temperatures hover in the triple digits all summer, and like almost everyone else in this desert region, the Evanses look to the lake to cool off.

It was on David Evans' birthday Sept. 8 that he brought Aaron, his other two children, and his parents to Lake Havasu. They ate sandwiches and spent a few hours splashing around.

"For a week, everything was fine," Evans said.

Then Aaron got the headache that wouldn't go away. At the hospital, doctors first suspected meningitis. Aaron was rushed to another hospital in Las Vegas.

"He asked me at one time, 'Can I die from this?'" David Evans said. "We said, 'No, no.'"

On Sept. 17, Aaron stopped breathing as his father held him in his arms.

"He was brain dead," Evans said. Only later did doctors and the CDC determine that the boy had been infected with Naegleria.

"My kids won't ever swim on Lake Havasu again," he said.


Bridgeport mourns principal as state investigates 2nd Legionnaire's case
LINDA CONNER LAMBECK lclambeck@ctpost.com
10/04/2006 09:26:27 AM EDT

BRIDGEPORT — Garfield School Principal Howard Reed lost his battle with Legionnaires' disease late Monday as state health officials announced a second case of the disease had been reported in West Haven, where Reed lived.
State officials would not identify the second person but said that individual is hospitalized.

Gov. M. Jodi Rell on Tuesday asked Public Health Commissioner J. Robert Galvin to seek assistance from the federal Centers for Disease Control and Prevention to investigate.  Galvin will comply, said state health department spokesman William Gerrish, but there are no plans to test Garfield School for the bacteria.

Legionnaires' disease is a bacterial respiratory illness spread through the air from a soil or water source. It has been reported 30 times in Connecticut, resulting in six deaths.  The diagnosis of two West Haven residents within a week is regarded as unusual, state officials said.  Rell said her request for CDC support is not an indication of a suspected outbreak, but rather a prudent step because two cases have been identified in one town.

The disease is not spread from person to person and is uncommon in children. Most susceptible are older adults with underlying health conditions.  Reed, 56, was a cancer survivor who also had diabetes.

The flag at Garfield School was lowered to half-staff Tuesday upon the news that Reed had died.  Reed's son, Matthew, who was with his father when he died late Monday, went to the school early Tuesday to break the news to staff, who, in turn, told their students.

"I felt this overwhelming responsibility for my dad to go to each classroom. I always heard he was in every classroom two to three times a day," he said. "I kind of wanted to take that walk that he would. It was important that I could do that for my dad."

In one classroom, he went in to comfort crying sixth-graders and ended up being the one comforted.

"Everyone picked up their heads. I sat down and talked with the kids. It was a very, very important moment. It's something my father would have wanted me to do," he said.

Luis Canales, head of the Parent-Teacher Association at Garfield, said Reed was an awesome man.

"Nothing short of inspiring. He was very calm. He dealt with situations on an individual basis. He had a very easy touch," he said.

Canales added that he was comfortable sending his son to the Garfield School because the state approved it.

"If the state says it's OK, then you have to take their word for it," he said.

Services for Reed are planned Saturday at noon at St. Peter's Church in Milford. Matthew Reed is trying to hire a school bus to transport students who want to attend the service.  Matthew Reed said his father came home sick on Sept. 22. Two days later, he was having problems breathing. The next morning, his wife convinced her husband to go to the hospital. Several hours later, he was on full life support, his son said.  That evening, they got the diagnosis of Legionnaires' disease.

Matthew Reed, 33, who lives in Indiana, expressed frustration with the apparent lack of response to his father's case by local and state health officials and by the school system.  Reed said that when Supt. of Schools John Ramos and Robert Henry, the superintendent's chief of staff, called him while his father was ill, the gist of the message was, "Please do not speak to the press."

Henry said his message was misinterpreted. "It was the simple indication that given the family situation, they should concentrate on their family," he said.

Matthew Reed talked briefly with Mayor John M. Fabrizi on Tuesday and requested a face-to-face meeting. Fabrizi went to the schools at lunchtime to talk to teachers and parents. He said Reed made a significant impact on everyone in the school.

"It's a huge loss for the school, district and city. He was a sensational guy," Fabrizi said.

Through a spokesman, Ramos said the school district was deeply saddened by the loss of Reed.

"He was a professional who loved his job and the Garfield community. He was trained as an attorney and brought a lot of wisdom, a sense of humor and dedication to the mission of our school district," he said.

Henry said while there are no plans to test the school, the district will put Garfield on the top of the list of schools where a new air-quality testing program will begin.  The program trains teachers, parents and staff on how to improve air quality in the schools by identifying, among other things, faulty ventilation systems.  The 95-year-old building does not have central air conditioning, but an air-conditioning unit cools its office suite. Officials insist it is not the type of air conditioner that would breed the Legionnaires' bacteria.

Matthew Reed can't understand the resistance to testing.

"I'm frustrated because I know that the only concern my father would have is the kids, and staff," he said. "And, yes, Legionnaires' is rare and for most people not deadly, but I have begged the health department to test [my parents'] home, church and the school."

Page last updated at 12:58 GMT, Thursday, 25 March 2010

China faces 'diabetes epidemic', research suggests
Patients at a weight reduction clinic in Tianjin, northern China (file picture)
A change in lifestyle following rapid economic growth is partly to blame

China faces a diabetes epidemic, with almost one in 10 adults having the disease while most cases remain undiagnosed, researchers have said.

Tests showed diabetes was more endemic than previously thought, according to the New England Journal of Medicine.

The figures suggest China has some 90 million diabetics, far more than India.

Rapid economic growth has affected public health, through urbanisation, changed diets and more sedentary lifestyles, researchers said.

Rigorous new tests suggested that more than 92 million Chinese adults had diabetes and that nearly 150 million more were showing early symptoms, researchers said.

This represents a major public health problem for the authorities in Beijing as diabetes is a major factor in illnesses such as heart disease, stroke and kidney disease, correspondents say.

"In the last 10 years, with the country's economy expanding quickly and people's standard of living improving, people's lifestyles have changed," said Yang Wenying, one of the report's 20 authors, who is head of endocrinology at Beijing's China-Japan Friendship Hospital.

"China's economic development has gone from a situation of not being able to eat enough, of poverty, to having enough food and warm clothes, and doing much less exercise," she told the AFP news agency.

Comparison of diabetes prevalence

The US has a similar percentage of sufferers, but China with its massive population now has more diabetics than anywhere else in the world, says the BBC's Michael Bristow in Beijing.

The Chinese study was based on a representative sample of more than 46,000 adults aged 20 years or older from 14 provinces and municipalities.

Last year, US research suggested that diabetes was becoming a global problem, with more than 60% of all cases likely to occur in Asia.




And Boston...
Cholera cases climb to 111 in Venezuela
YAHOO
Fri Jan 28, 2011 4:55 pm ET

CARACAS, Venezuela – The number of cholera cases has jumped to 111 in Venezuela as more people tested positive after attending a wedding with contaminated food in the Dominican Republic, the country's health minister said Friday.

The patients were all receiving treatment, and 27 were hospitalized, Health Minister Eugenia Sader told the Caracas-based television network Telesur.

The number of cases rose swiftly on Friday. Venezuelan authorities had said a day earlier that 37 people had the virus in the country and that 12 others were hospitalized in the Dominican Republic.

Dominican officials said wedding guests became infected when they ate tainted lobster at a wedding Jan. 22. Health Minister Bautista Rojas said lobsters for the lavish celebration were bought in Pedernales, a town bordering Haiti, where more than 3,000 people have died from a cholera epidemic.  Many of the 452 guests were Venezuelans, and health officials hope to provide treatment to all of them to keep the illness from spreading, Sader said. She has said several who returned to Madrid, Mexico and Boston also have cholera.

The Massachusetts health department said Friday that six state residents tested positive after attending the wedding, but all were released from local hospitals and officials were not concerned the disease could spread.

Jose Rodriguez, a vice minister in the Dominican Health Department, said the wedding menu consisted of 25 dishes, so not everyone ate the lobster.  Clemente Terrero, an infectious disease specialist and member of the Dominican Medical Association, questioned the reliability of government statistics on cholera.

"It is not possible that so many people became infected with cholera at one party, and that only 300 cases have been reported in the Dominican Republic in three months," he said.

Cholera fears have led to mass deportations of Haitian migrants since the beginning of the year. One death has been reported in the Dominican Republic.  Cholera, which causes severe diarrhea that can lead to dehydration and death, is spread through fecal-contaminated water and food. It had been rare in the Americas recently, until the outbreak in Haiti.

A large outbreak centered in Peru in 1991 spread to other countries and a total of 396,536 cases were reported throughout the Americas that year, according to the Pan American Health Organization. However a massive public health program subsequently helped all but eliminate the disease in the region, with just 13 known cases in 2006.

Before this month, Venezuela had not reported any cholera cases since 2000.
9 November 2010 Last updated at 13:38 ET
Haiti: Cholera confirmed in Port-au-Prince

The health ministry in Port-au-Prince has confirmed that the country's cholera epidemic has reached the Haitian capital.

Doctors are treating 73 people for cholera, amid fears the disease could spread across the quake-hit city.  Dozens of suspected cases are also being investigated, which has feared an outbreak since October. 
The country's health ministry says 583 people have died in Haiti's epidemic, and more than 9,000 are being treated.  Several cases were in fact confirmed in Port-au-Prince in the first few weeks of Haiti's cholera outbreak.

All of those affected had recently arrived in the city from the Artibonite region, where the disease was first detected.  Many of the current patients as well as people with suspected cholera had also come to Port-au-Prince from elsewhere in Haiti, including the Artibonite Valley, a health ministry official told the AP news agency.

But the ministry confirmed that at least one patient, a 3-year-old boy, had caught the disease although he had not recently travelled or been in contact with anybody from the Artibonite region.

Outbreak 'likely'

Health minister Ariel Henry said that a sizeable outbreak in Port-au-Prince now appeared likely.

"It's coming," Mr Henry told the AFP news agency.

He also said that at least one person in Port-au-Prince had died of the disease.  On Tuesday the ministry said across Haiti the death toll from the epidemic had risen to 583, from 544 on Monday.  The number of sick people receiving treatment had risen from 8000 to more than 9000 within 24 hours, the ministry said.  The water-borne disease has already spread to half of Haiti's 10 regions.

Authorities feared the outbreak could worsen after Hurricane Tomas brought heavy rains last week, which triggered mudslides and flooding.  The storm left 20 people dead, with 36 injured and 11 missing, officials said.  Aid agencies say the main concern is that the flooding could result in the spreading of cholera, with people lacking access to basic sanitation and forced to drink contaminated water.

The hurricane passed without destroying the tented camps in and around Port-au-Prince, which house about 1.3 million survivors of January's earthquake.  Aid workers say those living in the tent cities have better access to toilets and clean drinking water than the residents of some of the capital's long-standing slums, says the BBC's Laura Trevelyan in Port-au-Prince.  But if more cases are confirmed, the epidemic could threaten an estimated 2.5 to 3 million people in Port-au-Prince.

Cholera itself causes diarrhoea and vomiting, leading to severe dehydration. It can kill quickly but is treated easily through rehydration and antibiotics.
25 October 2010 Last updated at 12:05 ET
Haiti cholera outbreak causes not clear, experts say
Vibrio Cholerae, bacterium that causes Cholera in humans Until the current outbreak, cholera had not been documented in Haiti since 1960
By Sigrun Rottmann BBC News

The cholera outbreak in central Haiti that so far has killed more than 250 people and infected more than 3,000 is the worst health challenge the country faces since the earthquake in January.  There had been no documented outbreak of the disease in Haiti since 1960.  The US Centers for Disease Control and Prevention (CDC) said after the earthquake that while cholera testing should be carried out, the disease was "extremely unlikely to occur".

So why has the epidemic struck now?  It is not clear if the cause of the outbreak will ever be identified, but health experts agree that for cholera to occur, bad sanitation and hygiene have to coincide with people carrying the Vibrio Cholerae bacterium.  Sanitary conditions were poor in many parts of Haiti even before the earthquake, and Dr Brigitte Vasset from the international humanitarian organisation Medecins Sans Frontieres (MSF) in Paris is reluctant to link the outbreak directly with the quake.

"Central Haiti - where most people have been infected - was not the region most affected by the earthquake," she says.

While many displaced people might have sought refuge in the Artibonite region after the disaster, cholera bacteria could have been present in the Artibonite river or a stagnant water source even before the earthquake, Dr Vasset says.

She also points out that while no cases of cholera have been reported from rural areas, this does not mean that it has been completely absent.

"In many African countries there are sporadic cases during the year, then the weather changes or other conditions change, and all of a sudden there is an outbreak," Dr Vasset says, adding that the disease is difficult to predict.

"I have worked in refugee camps where we expected a cholera outbreak - and it never came," she says.

Sarah Morgan, Senior Health Programme Adviser at aid agency World Vision, agrees that it is possible low-level cholera was present in Haiti all along.

"Surveillance data on cholera in Haiti are not available," she says. However, watery diarrhoea has been common in the country, causing 5% to 16% of the deaths among Haitian children, according to CDC data.

With diarrhoea so prevalent and no stringent monitoring by health authorities and 80% of those with symptoms showing only moderate signs of infection, sporadic cases of cholera might not have registered.

"While there might have been no significant outbreak of cholera, it is possible that there was a background level of the disease," Ms Morgan says.

That cholera has now been picked up so quickly after the outbreak in the Artibonite region is a great success for Haiti's health authorities and international organisations working the country, she adds.
On the rise

Cholera is widespread and on the rise, with three to five million cases worldwide, the World Health Organization says.

More than 100,000 people die from the disease every year, with the majority of cases in Sub-Saharan Africa. Epidemics of Vibrio Cholerae are caused by one of two strains: 01, which has been identified as the cause of the current epidemic in Haiti, and the South-East Asian strain 0139.

It is difficult to get a complete picture of the global spread of the disease, because some countries are reluctant to report cholera for fear of travel sanctions, says Adam Kamradt-Scott from the London School of Hygiene and Tropical Medicine.

Mr Kamradt-Scott points out that around 75% of people infected with Vibrio Cholerae do not develop symptoms. But they excrete the bacterium with their faeces for up to 14 days - a potential source of infection for others.  With more people and aid coming to Haiti since the earthquake in January, there is a possibility that the bacterium was brought to the country from the outside, Mr Kamradt-Scott says.

"The bacteria can be resident in water for a quite a while," Mr Kamradt-Scott explains and points to a cholera outbreak in Peru in 1991.

There was speculation that that epidemic, which quickly spread across Latin America, came from bilge water and algae dumped by an Asian cargo ship, contaminating local shellfish.  In Haiti, the disease has more likely been spread because people used the Artibonite river for washing and drinking.

"As soon as people have been infected and excrete the bacteria, the epidemic spreads very quickly," Mr Kamradt-Scott says.

"It is then important to break the cycle of the disease," he adds.

Because Vibrio Cholerae produces toxins that lead to watery diarrhoea, patients need to be rehydrated with liquids containing sugar and salt or with intravenous fluids.  Those infected need to receive treatment immediately, Mr Kamradt-Scott says. If not treated, the death-rate of cholera can rise up to 50%.  But the potentially deadly cholera cycle can only be broken when people also stay away from the contaminated water source until the bacteria have cleared, he adds.


Cholera Case Is Confirmed in Pakistan
By THE ASSOCIATED PRESS
Filed at 8:04 a.m. ET
August 14, 2010

ISLAMABAD (AP) -- A case of the deadly waterborne disease cholera has been confirmed in Pakistan's flood-ravaged northwest, and aid workers expect there to be more, the U.N. said Saturday. The discovery came as new flood surges hit the south and the prime minister said the deluge has made 20 million people homeless.

The flooding disaster has battered Pakistan's economy and undermined its political stability at a time when the United States needs its steadfast cooperation against Islamist extremism. The U.N. has appealed for an initial $460 million to provide relief to Pakistan but has said the country will need billions to rebuild once the flood recedes.

Because of the crisis, Pakistan canceled celebrations Saturday marking its creation and independence from Britain in 1947. President Asif Ali Zardari met with flood victims in the northwest, and U.N. Secretary-General Ban Ki-moon was expected to visit country soon, possibly over the weekend.

The floods have killed about 1,500 people, and aid workers have warned that diseases could raise that toll.

One case of cholera was confirmed in Mingora, the main town in the northwest's Swat Valley, U.N. spokesman Maurizio Giuliano said Saturday. Other cases were suspected, and aid workers are now responding to all those exhibiting acute watery diarrhea as if it is cholera, Giuliano said.

Cholera can lead to severe dehydration and death without prompt treatment, and containing cholera outbreaks is considered a high priority following floods.

The Pakistani crisis began in late July, when unusually heavy monsoon rains tore through the country from its mountainous northwest. Hundreds of thousands of homes have been destroyed. Agriculture has been severely hit, with an estimated 1.7 million acres (nearly 700,000 hectares) of farmland wiped out.

U.N. officials, citing government figures, have said around 14 million Pakistanis were directly or indirectly affected.

But in a televised address to the nation Saturday, Prime Minister Yousuf Raza Gilani said 20 million were now homeless. He did not elaborate, and it was unclear how many of those people were briefly forced to leave their homes and how many had lost their houses altogether.

Later Saturday, Gilani agreed to a proposal from opposition leader Nawaz Sharif that an independent body be appointed to raise relief funds and oversee their spending in a transparent manner to boost Pakistan's credibility in the eyes of the international community.

The two made the announcement amid signs that the global response to the flooding has been less generous than to previous calamities. Some aid experts have said perceived corruption in the government could be holding back some donors.

Fresh flood waves swelled the River Indus on Saturday, threatening nearby cities, towns and villages in southern Sindh province, said Mohammed Ajmal Shad, a senior meteorologist. The Indus was already more than 15 miles (25 kilometers) wide at some points -- 25 times wider than during normal monsoon seasons.

Authorities were trying to evacuate or warn people in Jacobabad, Hyderabad, Thatta, Ghotki, Larkana and other areas. Already, many flood victims are living in muddy camps or overcrowded government buildings, while thousands more are sleeping in the open next to their cows, goats and whatever possessions they managed to drag with them.

''My house was swept away in the floodwater. I have no shelter, no clothes and nothing to eat. I am living in misery,'' said Allah Wasai of Muzzafargarh, a flood-hit region in Punjab province. ''I lost everything. I'm now at God's mercy.''

The damage to the Pakistani government's credibility, which was already shaky, may be hard to repair, especially after fury caused by Zardari's decision to visit Europe as the crisis was unfolding. Zardari has tried to make up for that public relations gaffe by meeting with flood victims in hard-hit areas since returning.

''We are with you. Pakistan is with you, and the people of Pakistan are with you,'' he told survivors at a relief camp in the northwest's Nowshehra city Saturday. He promised the government would rebuild victims' homes.

The United States has donated the most to the relief effort, at least $70 million, and has sent military helicopters to rescue stranded people and drop off food and water. Washington hopes the assistance will help improve its image in the country -- however marginally -- as it seeks its support in the battle against the Taliban in neighboring Afghanistan.

''So far, if anyone has practically given us maximum help, it is America,'' Gilani said Saturday when a Pakistani reporter suggested the U.S. has done little since the crisis started.

As President Barack Obama congratulated Pakistan on its Independence Day, which also marked the Muslim-majority nation's separation from India, he insisted the U.S. would not abandon the country in its time of need.

''We will remain committed to helping Pakistan and will work side by side with you and the international community toward a recovery that brings back the dynamic vitality of your nation,'' Obama said in a statement.

How news spreads...forst the Internet, then AP.
Japan confirms its first case of new superbug gene
YAHOO
Tue Sep 7, 4:36 am ET

TOKYO – Japan has confirmed the nation's first case of a new gene in bacteria that allows the microorganisms to become drug-resistant superbugs, detected in a man who had medical treatment in India, a health ministry official said Tuesday.  The gene, known as NDM-1, was found in a Japanese man in his 50s, health ministry official Kensuke Nakajima said.

Researchers say the gene — which appears to be circulating widely in India — alters bacteria, making them resistant to nearly all known antibiotics.  The man was hospitalized in April 2009 after returning from India where he had medical treatment. Nakajima declined to say what kind of treatment the man had received in India, citing the man's privacy.

The man had a high fever while staying at a hospital in Tochigi, north of Tokyo. He was discharged in October last year.

The hospital — Dokkyo Medical University Hospital — kept a preserved sample of the suspected superbug from the man. The hospital examined the sample after the British medical journal Lancet reported about the NDM-1 in August.  The Tochigi hospital notified the health ministry about the detection of the NDM-1 gene. It told the ministry that no in-hospital infections were found.

Following the discovery of Japan's first superbug case, the health ministry launched a nationwide survey on the NDM-1 gene, asking local health authorities to check on hospitals. 
Though already widespread in India, the new superbug gene has been detected in Australia, Canada, the United States, the Netherlands, Sweden and the U.K.

Researchers say since many Americans and Europeans travel to India and Pakistan for elective procedures like cosmetic surgery, it was likely the superbug gene would spread worldwide.




Data from individual countries such as the UK suggests that dementia is already one of the costliest illnesses.

21 September 2010 Last updated at 06:19 ET
Dementia cost 'to top 1% of GDP'
By Michelle Roberts Health reporter, BBC News

The costs associated with dementia will amount to more than 1% of the world's gross domestic product this year at $604bn (£388bn), a report says.  The World Alzheimer Report says this is more than the revenue of retail giant Wal-Mart or oil firm Exxon Mobil.  The authors say dementia poses the most significant health and social crisis of the century as its global financial burden continues to escalate.

They want the World Health Organization to make dementia a world priority.  Campaigners say more investment in dementia care and research into new treatments is needed. Spending more money now would save nations more money in the future by decreasing the disease burden, they say.

A large part of the problem is people living longer - as life expectancy goes up around the world there will be more people who will develop dementia.

'Substantial investments'

The number of people with dementia is expected to double by 2030, and more than triple by 2050.

But experts say the costs of caring for people with dementia are likely to rise even faster than the prevalence, especially in the developing world, as more formal social care systems emerge and rising incomes lead to higher opportunity costs.  Data from individual countries such as the UK suggests that dementia is already one of the costliest illnesses.

The report brings together the best available data and the most recent insights regarding the worldwide economic cost of dementia.  It calls on the World Health Organization to declare dementia as a world health priority.

WHAT IS DEMENTIA?

    * Dementia is an umbrella term which describes a serious deterioration in mental functions, such as memory, language, orientation and judgement.
    * There are many types, but Alzheimer's disease, which accounts for two thirds of cases, is the most well-known.

Professor Martin Prince, of the UK's Institute of Psychiatry and who co-authored the report, urged nations to develop better plans for caring for the millions who have the disease.

"Governments must show greater leadership, working with all stakeholders, to drive solutions to the long term care issue."

Marc Wortmann, head of Alzheimer's Disease International, an umbrella group of organisations, said: "The scale of this crisis cries out for global action.

"History shows that major diseases can be made manageable - and even preventable - with sufficient global awareness and the political will to make substantial investments in research and care options."

Dementia experts say governments must lead the way in ensuring national dementia strategies are fully implemented and dementia research is given enough funding to find new tests, treatments and possibly a cure.


Outbreak in Tibet recently (l);  China host, and the marmot or vole, perhaps the culprit!

Plague Rare in U.S., Surfacing in More Affluent Areas
YAHOO
By Steven Reinberg, HealthDay Reporter
14 June 2012  

WEDNESDAY, June 13 (HealthDay News) -- Although the plague is typically considered a remnant of the Middle Ages, when unsanitary conditions and rodent infestations prevailed amid the squalor of poverty, this rare but deadly disease appears to be spreading through wealthier communities in New Mexico, researchers report.  Why the plague is popping up in affluent neighborhoods isn't completely clear, the experts added.

"Where human plague cases occur is linked to where people live and how people interact with their environment," noted lead researcher Anna Schotthoefer, from the Marshfield Clinic Research Foundation in Wisconsin. "These factors may change over time, necessitating periodic reassessments of the factors that put people at risk."

This latest study confirms previous reports that living within or close to the natural environments that support plague is a risk factor for human plague, Schotthoefer said.  Plague is caused by a fast-moving bacteria, known as Yersinia pestis, that is spread through flea bites (bubonic plague) or through the air (pneumonic plague).  The new report comes on the heels of the hospitalization on June 8 of an Oregon man in his 50s with what experts suspect is plague. According to The Oregonian, the man got sick a few days after being bitten as he tried to get a mouse away from a stray cat. The cat died days later, the paper said, and the man remains in critical condition.

For the new study, published in the July issue of Emerging Infectious Diseases, the researchers used U.S. Census Bureau data to pinpoint the location and socioeconomic status of plague patients.

About 11 cases of plague a year have occurred in the United States since 1976, with most cases found in New Mexico. Plague has also been reported in a handful of other states.

Although many cases were in areas where the habitat supports rodents and fleas, the researchers also found cases occurring in more upper-class neighborhoods. In the 1980s, most cases occurred where housing conditions were poor, but more recently cases have been reported in affluent areas of Santa Fe and Albuquerque, the investigators found.

"The shift from poorer to more affluent regions of New Mexico was a surprise, and suggests that homeowners in these newly developed areas should be educated about the risks of plague," Schotthoefer said.

Schotthoefer noted that these more affluent areas where plague occurred were regions where new housing developments had been built in habitats that support the wild reservoirs of plague, which include ground squirrels and woodrats.

Bubonic plague starts with painful swellings (buboes) of the lymph nodes, which appear in the armpits, legs, neck or groin. Buboes are at first a red color, then they turn a dark purple color, or black. Pneumonic plague starts by infecting the lungs. Other symptoms include a very high fever, delirium, vomiting, muscle pains, bleeding in the lungs and disorientation.

In the 14th century, a plague called the Black Death killed an estimated 30 percent to 60 percent of the European population. Victims died quickly, within days after being infected.

Infectious disease expert Dr. Marc Siegel, an associate professor of medicine at NYU Langone Medical Center in New York City, said he doesn't expect to see that kind of outbreak ever again.

"This is not a disease of the past, but you are never going to see a massive outbreak of plague in this country," he said.

"We don't have the public health problems we used to have and people would be quickly confined if there were ever a large number of cases," Siegel explained.

Yet, it is not surprising to see plague in these more affluent areas, he noted.

"We know that plague only exists where you have wild animals, and once a reservoir of plague is already present it is likely to persist," Siegel explained. "It isn't only about squalor; it's about where the reservoir is."

However, if the disease is caught early it is treatable with antibiotics, Siegel added.
Europe’s Plagues Came From China, Study Finds
NYTIMES
By NICHOLAS WADE
October 31, 2010

The great waves of plague that twice devastated Europe and changed the course of history had their origins in China, a team of medical geneticists reported Sunday, as did a third plague outbreak that struck less harmfully in the 19th century.

And in separate research, a team of biologists reported conclusively this month that the causative agent of the most deadly plague, the Black Death, was the bacterium known as Yersinia pestis. This agent had always been the favored cause, but a vigorous minority of biologists and historians have argued the Black Death differed from modern cases of plague studied in India, and therefore must have had a different cause.

The Black Death began in Europe in 1347 and carried off an estimated 30 percent or more of the population of Europe. For centuries the epidemic continued to strike every 10 years or so, its last major outbreak being the Great Plague of London from 1665 to 1666. The disease is spread by rats and transmitted to people by fleas or, in some cases, directly by breathing.

One team of biologists, led by Barbara Bramanti of the Institut Pasteur in Paris and Stephanie Haensch of Johannes Gutenberg University in Germany, analyzed ancient DNA and proteins from plague pits, the mass burial grounds across Europe in which the dead were interred. Writing in the journal PLoS Pathogens this month, they say their findings put beyond doubt that the Black Death was brought about by Yersinia pestis.

Dr. Bramanti’s team was able to distinguish two strains of the Black Death plague bacterium, which differ both from each other and from the three principal strains in the world today. They infer that medieval Europe must have been invaded by two different sources of Yersinia pestis. One strain reached the port of Marseilles on France’s southern coast in 1347, spread rapidly across France and by 1349 had reached Hereford, a busy English market town and pilgrimage center near the Welsh border.

The strain of bacterium analyzed from the bones and teeth of a Hereford plague pit dug in 1349 is identical to that from a plague pit of 1348 in southern France, suggesting a direct route of travel. But a plague pit in the Dutch town of Bergen op Zoom has bacteria of a different strain, which the researchers infer arrived from Norway.

The Black Death is the middle of three great waves of plague that have hit in historical times. The first appeared in the 6th century during the reign of the Byzantine emperor Justinian, reaching his capital, Constantinople, on grain ships from Egypt. The Justinian plague, as historians call it, is thought to have killed perhaps half the population of Europe and to have eased the Arab takeover of Byzantine provinces in the Near East and Africa.

The third great wave of plague began in China’s Yunnan province in 1894, emerged in Hong Kong and then spread via shipping routes throughout the world. It reached the United States through a plague ship from Hong Kong that docked at Hawaii, where plague broke out in December 1899, and then San Francisco, whose plague epidemic began in March 1900.

The three plague waves have now been tied together in common family tree by a team of medical geneticists led by Mark Achtman of University College Cork in Ireland. By looking at genetic variations in living strains of Yersinia pestis, Dr. Achtman’s team has reconstructed a family tree of the bacterium. By counting the number of genetic changes, which clock up at a generally steady rate, they have dated the branch points of the tree, which enables the major branches to be correlated with historical events.

In the issue of Nature Genetics published online Sunday, they conclude that all three of the great waves of plague originated from China, where the root of their tree is situated. Plague would have reached Europe across the Silk Road, they say. An epidemic of plague that reached East Africa was probably spread by the voyages of the Chinese admiral Zheng He who led a fleet of 300 ships to Africa in 1409.

“What’s exciting is that we are able to reconstruct the historical routes of bacterial disease over centuries,” Dr. Achtman said.

Lester K. Little, an expert on the Justinian plague at Smith College, said in an interview from Bergamo, Italy, that the epidemic was first reported by the Byzantine historian Procopius in 541 A.D. from the ancient port of Pelusium, near Suez in Egypt. Historians had assumed it arrived there from the Red Sea or Africa, but the Chinese origin now suggested by the geneticists is possible, Dr. Little said.

The geneticists’ work is “immensely impressive,” Dr. Little said, and adds a third leg to the studies of plague by historians and by archaeologists.

The likely origin of the plague in China has nothing to do with its people or crowded cities, Dr. Achtman said. The bacterium has no interest in people, whom it slaughters by accident. Its natural hosts are various species of rodent such as marmots and voles, which are found throughout China.
5 infected with deadly pneumonic plague in Tibet
YAHOO
Sun Sep 26, 2:59 am ET

BEIJING – Chinese authorities say five people have been sickened with pneumonic plague in Tibet and that the deadly disease has killed one of them.

The Tibetan regional health department says the cases were reported in Laduo, a village in Lang county in the remote region.

The department said in a statement Sunday that the first case was found Sept. 23 and that the patient died of a severe lung infection. The remaining four people have been quarantined.

The disease can kill in as few as 24 hours if left untreated.

Last year, an outbreak of the disease in a farming town in Qinghai province killed three people and sickened nine, prompting authorities to seal off the community of 10,000 people for more than a week.



Germany Concludes E. Coli Tainted Bean Sprouts
NYTIMES
By ALAN COWELL
June 10, 2011

BERLIN — After days of confusion, German authorities finally concluded on Friday that an E. coli infection, which has claimed at least 29 lives, unsettled the nation and thrown European agriculture into disarray, had been caused by contaminated bean sprouts and not, as first was feared, by other produce.

But, at a news conference here, Reinhard Burger, the head of the Robert Koch Institute — the country’s disease control agency — said the outbreak was “not yet over” because “there will be new cases coming up.”

Doubts about the cause of the illness have blossomed with the authorities first saying the infection came from imported Spanish cucumbers, tomatoes and lettuce. After initially warning consumers not to eat those products, the authorities said last weekend that contaminated bean sprouts were the source.

But tests carried out on bean sprout samples produced only negative results. At the news conference on Friday, Mr. Burger said investigations centering on interviews with patients and even the chefs at restaurants where they had eaten showed that people who had consumed bean sprouts were nine times more likely to become infected than those who had not.

No harmful bacteria had been found in any samples, he said. But from the pattern of the outbreak, he added, “It was possible to narrow down epidemiologically the cause of the outbreak of the illness to the consumption of sprouts.”

On Friday, Andreas Hensel, the head of Germany’s Risk Assessment Agency, said at the same news conference that authorities were no longer urging consumers to avoid cucumbers, lettuce and tomatoes. Sprouts should still be avoided, he said.

State authorities in Lower Saxony said they had sealed off the likely source of the suspect sprouts — a farm growing organic crops in Bienenbüttel, southeast of Hamburg — and ordered its operators to suspend sales of any other products. Gert Lindemann, the state agriculture minister, said the owners of the farm had already pledged not to sell any produce after their facility came under suspicion last Sunday.

The outbreak has been particularly virulent because, the German authorities say, it has led to a potentially lethal complication that causes kidney failure and neurological damage. Almost 3,000 people have become sickened with E. coli and more than 700 of them suffered complications. In addition to 29 fatal cases in Germany, a death was reported in Sweden.

The announcement followed remarks late Thursday by the federal health minister, Daniel Bahr, who said there was “cause for justifiable optimism” that the outbreak was close to ending.

The outbreak spread alarm across Europe, with Spanish farmers demanding compensation after demand for their crops plummeted and farmers in Germany and other European countries saying the market for cucumbers, lettuce and tomatoes was so low that they were forced to dump tons of unsold produce.

In response to the spread of E. coli, Russia banned all imports of vegetables from Europe, causing an outcry among European farmers that one of its biggest markets had been closed down.

RUSSIA, SAUDI ARABIA
In some places, all vegetables suspect, even cukes.

Dutch find different E. coli, pull beet sprouts
YAHOO
By ARTHUR MAX, Associated Press
9 June 2011

AMSTERDAM – Dutch authorities recalled red beet sprouts from three countries Thursday after samples were found to be contaminated with a strain of E. coli bacteria that was apparently less dangerous than the one causing Europe's deadly E. coli crisis.

The Dutch Food Safety Authority said laboratories were still trying to identify the Dutch strain, but there have been no immediate reports of serious illness from it.

But the agency said it was definitely not the same E. coli strain that has killed 27 people, sickened 2,900 others and left hundreds with serious complications, most of them in Germany. The cause of that outbreak, which began May 2, has so far eluded German authorities.

Only one grower, a company called Hamu, was found with contaminated beets, and other produce grown on its farms were cleared of suspicion, said Esther Filon, a spokeswoman for the Dutch regulation agency.

"It's not the same as in Germany. You can become ill, but as far as we know at this moment, it is not lethal," she told the Associated Press.

She said the authorities were trying to trace all shipments from the grower.

The agency said Hamu, based in the town of Kerkdriel 44 miles (70 kilometers) southeast of Amsterdam, had exported beet sprouts to Belgium as well as selling them on the Dutch and German markets.

There are hundreds of E. coli bacteria strains in nature, but only a few are deadly to humans and the bacteria is more commonly known as a source of food poisoning or severe stomach problems.

People naturally carry several harmless E. coli strains in their intestines and the bacteria is also widely found in cows, sheep and other mammals. Strains which are harmless to animals can sometimes be lethal for humans. Experts worry about E. coli's constant evolution, which may result in dangerous mutations for humans.

The European Union informed the Netherlands late Wednesday that contaminated beet sprouts had been found in Germany, and tests in the Netherlands confirmed it.

In Berlin, the Robert Koch Institute said one more person died and 160 more were sickened in the E. coli outbreak but the rate of new illnesses was declining. It said 2,808 people have been sickened in Germany, 722 of whom are suffering from a serious complication that can cause kidney failure.

The World Health Organization says 97 others have fallen sick in 12 other European countries, as well as three in the United States.

The Koch institute says new cases being reported have been dropping for several days but cautioned that could be due to the fact that consumers are following the advice of health officials and staying away from cucumbers, tomatoes, lettuce and vegetable sprouts — all of which are being investigated as possible carriers of the E. coli.

European Union farmers say that since the warning went out, they have been losing up to euro417 million ($611 million) a week as ripe produce rots in fields and warehouses.

On Wednesday, the EU said it would offer farmers compensation of up to euro210 million ($306 million) for the E. coli losses, though a final decision will not be made until next week.

Russia and Saudi Arabia have issued a blanket ban on vegetable imports from the European Union.

Spanish farmers have been among the hardest hit, after authorities in Hamburg issued an early warning that Spanish cucumbers could be the source of the E. coli. Further tests showed that while the Spanish vegetables did carry E. coli, it was not the strain behind the outbreak.

In Berlin on Thursday, Spain's Secretary of State for European Affairs, Diego Lopez Garrido said the compensation being offered so far by the EU is not enough.

He also said both Spain and Germany believe the Russian ban on EU vegetables is "inappropriate." Russia is a huge market for EU produce.


Our experience:  In the late 1970's science could only tell you if you had this neurological disease, but not that you did not.
Ann Romney’s Winding Trail
By Katrina Trinko, National Review
June 19, 2012 4:00 A.M.

Ann Romney waited for the doctor to move her big toe.

The doctor pushed her toe up and down. But she never felt a thing.

“It was at that point that I just almost burst into tears,” Romney recalls in an interview. “And I realized, ‘I’m failing this test.’”

On the campaign trail, Ann Romney appears healthy, confidently strolling across stages to deliver the good-humored introductions of her husband that have charmed audiences in state after state. Sitting down for a talk with Mrs. Romney in the nation’s capital, it’s the same scenario: There is no visible sign of her multiple sclerosis, the disease that turned her life upside down 14 years ago. Dressed in jeans and a gray sweater layered over a white top, the 63-year-old Romney looks smart, her outfit pulled together with a white watch and a pendant necklace. As she tells her story, describing the ups and downs of living with MS, her expressions flicker between reflective, incredulous, and wry.

By being careful, including stringently minding her diet and making time for rest, Romney has managed to keep the symptoms under control to the point where she can participate fully in the campaign. But there was a time when she had good reason to fear she would never lead a normal life again — she imagined a future life spent in a wheelchair.

In 1998, Romney had a series of tests — including the one in which the doctor checked whether she could feel movement in her toe — and an MRI. The results led to a diagnosis of MS, an autoimmune disease that affects about 400,000 Americans, causes nerve damage, and can lead to vision problems, numbness, slurred speech, and constant fatigue, among other effects. There is no cure, although medical treatment can help those affected.

Normally, explains Timothy Coetzee, a doctor and the chief research officer of the National Multiple Sclerosis Society, a person’s immune system works to fight off viruses and bacteria. In the case of MS, the immune system acts very differently. “For reasons that we still don’t know, the immune system decides the brain is now the enemy and starts attacking specific parts of the brain and destroying a person’s nervous system,” Dr. Coetzee says.

Well before she was formally diagnosed, Romney had been feeling the effects of MS. A year or two before her diagnosis, for a spell of about four months, her right leg felt numb. But the busy mother of five sons brushed off the condition, reasoning that the numbness was probably related to a back problem.

That numbness eventually disappeared; but, by the fall of 1998, Romney was coping with an array of medical problems, including dizziness, weakness, tripping, and extreme fatigue. Walking through the lobby of Massachusetts General Hospital, where she served as a member on a cancer board, Romney thought, “I really need to go see somebody.” Her symptoms were such a strange hodgepodge, though, that she didn’t know what kind of doctor she should consult.

Romney finally called her brother Jim Davies, a doctor in San Diego. After she described her symptoms, Davies paused for a moment — and then told her she needed to see a neurologist. The neurologist referred her to an MS specialist.

When the specialist delivered the diagnosis, Romney had little opportunity to process how her life had changed. Her condition was rapidly deteriorating. For years, she and several friends had worked out with a personal trainer. One day, when it was time for a workout, the once-athletic Romney couldn’t find the strength to climb out of bed.

The personal trainer entered the bedroom where Romney was resting. “I remember her coming and literally climbing in my bed, and just moving my limbs, and I was just sitting there, just crying,” Romney says. She recalls thinking, “I can’t believe this — a month ago, I was working out, and I was fit.” Almost overnight, her physical strength had vanished.

Romney was horrified by how fast the disease was moving and her inability to halt it. “Where is this going to end, and how is this going to end?” she wondered. She viewed MS as a “monster” —  it refused to “spit me out,” she says.

A solution seemed elusive. The first treatment for MS wasn’t identified until 1993. Her doctor had no recommendations for treatment. (There have been significant improvements in treatment since Romney was diagnosed in 1998.) A frustrated Romney took matters into her own hands and consulted another doctor, Howard Weiner, a neurologist in Boston.

Her medical challenges were growing more serious. The numbness had spread from the tip of her toes to the middle of her upper body. She had no way of knowing when — or if — the process would halt.

When she had her appointment with Dr. Weiner, Romney cut to the chase, asking him, “When is this going to stop?” Unlike her other doctor, Dr. Weiner wanted to fight against the disease. “He took me by my hand,” Romney recalls. “He took me right to the infusion center, which is the chemotherapy-infusion center, sat me down, and said, ‘Start now — massive IV steroids and chemotherapy.’”

It was a way to potentially treat MS, but it wasn’t without pitfalls. “‘The theory has always been to not do this,’” Romney remembers Dr. Weiner explaining. Nonetheless, he argued strongly that she ought to do it: “He said we’ve discovered that the sooner you attack it, the harder you attack it, the better off people are,” Romney says. She took his advice and started the once-a-month treatment.

Treatment succeeded in reversing some of the numbness, but there was no instant miracle, and Romney’s personal life continued to unravel. Mitt Romney took over the laundry and cooking. (Asked what kind of cook he was, sons Tagg and Josh Romney say that Mitt Romney’s go-to meals are spaghetti, and pancakes with bacon.) “He made me feel really good about the things that I couldn’t do anymore,” Romney says of her husband. “I wasn’t able to go to the grocery store. I couldn’t cook dinners. I couldn’t do anything. And he just rolled right with it and just started doing everything.”

He also provided crucial emotional support. “His reaction was that we can deal with anything,” Romney remembers. “Together. We’re together. We’re okay, we can fight this, we can deal with anything.”

Mitt Romney learned more than how to manage a household during those difficult days that his wife was battling MS. “My dad likes to fix things,” observes Tagg Romney, the Romneys’ eldest son. But Ann Romney’s MS, Tagg continues, was a situation where there was “nothing he could fix.”

Of the five Romney sons, only the youngest, Craig, was still living at home. A senior in high school at the time, he faced questions from classmates who wanted to know how he felt about his mother dying. “Craig would come home so upset, and he’s like, ‘You didn’t tell me you were going to die,’” Romney remembers. “And I’m like, ‘No, that’s because I’m not.’ People had such misperceptions about it.”

In 1999, Romney faced another huge challenge: moving across the country to Utah, where she had no friends or community. Mitt Romney had been tapped to lead the Olympics, and the couple had initially hoped that Mitt would be able to fly back home to Massachusetts occasionally. Shortly after he started the job, however, it became clear that it would not be practical for him to be absent from Utah very often. They changed their plans. Matt Romney, the couple’s second son, would move into the family home in Massachusetts so that Craig Romney could finish his senior year in the state. And Ann Romney would move to Utah.

“I left everything that I knew,” she says. But in her heart she was convinced it was the right decision to make — although she finds it hard in retrospect to imagine what she was thinking. “I was completely overwhelmed with grief and depression and everything when I left,” Romney remembers. She had lived in Massachusetts virtually her entire adult life.

In Utah, Romney worked to develop a routine. Josh Romney, the third of the Romney sons, was living in Salt Lake City at the time, and mother and son met regularly for lunch, often at a bagel shop near Josh. “We spent a lot of time just trying to talk things through,” he recalls. Mitt Romney juggled the household chores and running the Olympics. On his drive home, he would sometimes stop at Albertson’s, a grocery store in Park City, to pick up dinner. One favorite meal was rotisserie chicken, accompanied by side dishes of broccoli and pita bread.

Through all this, Ann Romney wondered how long her ability to walk, even with difficulty, would last. She recalls thinking, “I’m pretty sure I’m going to end up in a wheelchair, pretty sure I’m going to be really bad.” She resolved to take action and made a decision: “I want to do things that I love so much in life before I can’t do them anymore.”

So Romney bought a horse, Buddy. Romney is quick to tell me that Buddy wasn’t an “expensive” horse. “Having him,” she says, “was like the coolest thing in the world.” Buddy was a trail and first-level dressage horse, and he was Romney’s companion in those days. “I was pretty lonely,” she admits.

Buddy’s stable was a 35-minute drive from the Romneys’ Utah home. Once at the stable, Romney would spend hours and hours with Buddy, grooming him and cleaning out his stall. Still very weak, she could barely ride the horse: “I could only ride, like really ride, for like five minutes” before getting too worn out.

But Romney’s affection for Buddy transformed her outlook on life and gave her a reason to push herself to climb out of bed each morning. “I noticed that I had this euphoria afterwards — it kind of got me out of that fatigue place for a little bit, just for a little time,” she says of her riding. Slowly, she began to feel slightly stronger.

Time passed. And then Mitt Romney nominated his wife — without telling her — to carry the Olympic torch, citing her as his personal hero. It would be an arduous task for her: Those who carry the Olympic torch run for a quarter-mile before relaying the torch to the next person. For weeks beforehand, Romney practiced, building up her strength.

“She was able to jog the whole thing,” remembers Josh Romney, who was there with her, running alongside his mom.

“I literally ran,” Romney says, describing how she carried the torch, with friends and some of her sons present. “My kids were all surrounding me,” she says. “And they were all crying because they knew what a miracle it was that I came [to Utah] barely able to walk and now [here] I was, three years later, torch in hand, the Olympics were a success, I was back on track, I was regaining my strength, and off I ran with this torch into the city.”

Those who had watched her grapple with the disease were amazed to see how much she had regained her strength. “We recognized she would be better, that she could live a healthy and normal life,” Josh Romney says.

For a decade now, Romney’s MS has been in remission. That doesn’t mean, however, that her symptoms have vanished entirely. On occasion, she must contend with dizziness and memory loss. Still, Romney is optimistic about the future. “If you’ve got ten years of remission, you can pretty much look forward to ten more years,” she says, adding that she has not suffered any more nerve damage in recent years.

She can never forget to be careful, though. She’s very much aware of the dangers of overextending herself during this time. “I know I’m walking a tightrope,” she says. “I know that I can fall off very easily and quickly.”

Looking back, Romney views the Utah sojourn with gratitude. It was one of “the greatest blessings in our life,” she says. Moving to Utah “was the best decision I ever made . . . because during those three years, I completely regained my strength, went into remission with MS, [and] had this enormous love of horses renew my soul.”

The Utah move also gave Romney an understanding of what it’s like to plunge into a new experience without knowing what the outcome will be. Sometimes, Romney reflects, “you just have to have the courage to step in a scary doorway [and] you don’t know where it’s going to lead you.” That’s what she’s doing now, campaigning across the country with and for her husband. For Ann Romney, the unknown beyond the White House doorway is probably the second-most daunting prospect she has faced.