Wednesday, October 31, 2012
Tuesday, October 30, 2012
A Weak Spot in H.I.V’s Armor Raises Hope for a Vaccine
The following is an excerpt of an article in:
The New York Times
Tuesday, October 30, 2012
A Weak Spot in H.I.V’s Armor Raises Hope for a Vaccine
By DONALD G. McNEIL Jr.
The search for a vaccine against AIDS has been long and fruitless — mostly because the virus mutates so fast.
As is well known, flu vaccines have to be reformulated every year because influenza viruses mutate so steadily. But the human immunodeficiency virus, which causes AIDS, mutates as much in a single day as flu virus does in a year, presenting scientists with an almost insurmountable challenge.
This month, South African researchers announced that they had found a vulnerable spot on the virus’s outer shell that might present a good vaccine target, and that they had also learned, for the first time, at what stage of an infection it develops. They found only two women whose virus had the vulnerability — and it wasn’t the same virus that first infected them, but a mutant that developed a few months later.
The research, published by Nature Medicine on Oct. 21, was praised as “very interesting” by several AIDS experts.
“It’s a combination of good science and ‘Boy, did we get lucky,’ ” said Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases. “They had all these blood samples and virus samples.”
The researchers, led by Dr. Salim Abdool Karim, president of South Africa’s Medical Research Council and best known for pioneering work on vaginal microbicides, screened hundreds of blood samples given at regular intervals by 79 women who had been in earlier clinical trials at his Durban clinic and had become infected during the trials.
“What we have that’s unique,” Dr. Karim said, “is that for the first time, we understand how a person can make broadly neutralizing antibodies.”
The New York Times
Tuesday, October 30, 2012
A Weak Spot in H.I.V’s Armor Raises Hope for a Vaccine
By DONALD G. McNEIL Jr.
The search for a vaccine against AIDS has been long and fruitless — mostly because the virus mutates so fast.
As is well known, flu vaccines have to be reformulated every year because influenza viruses mutate so steadily. But the human immunodeficiency virus, which causes AIDS, mutates as much in a single day as flu virus does in a year, presenting scientists with an almost insurmountable challenge.
This month, South African researchers announced that they had found a vulnerable spot on the virus’s outer shell that might present a good vaccine target, and that they had also learned, for the first time, at what stage of an infection it develops. They found only two women whose virus had the vulnerability — and it wasn’t the same virus that first infected them, but a mutant that developed a few months later.
The research, published by Nature Medicine on Oct. 21, was praised as “very interesting” by several AIDS experts.
“It’s a combination of good science and ‘Boy, did we get lucky,’ ” said Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases. “They had all these blood samples and virus samples.”
The researchers, led by Dr. Salim Abdool Karim, president of South Africa’s Medical Research Council and best known for pioneering work on vaginal microbicides, screened hundreds of blood samples given at regular intervals by 79 women who had been in earlier clinical trials at his Durban clinic and had become infected during the trials.
“What we have that’s unique,” Dr. Karim said, “is that for the first time, we understand how a person can make broadly neutralizing antibodies.”
For more, visit www.nytimes.com.
Scientists Move Closer to a Long-Lasting Flu Vaccine
The following is an excerpt from an article in:
The New York Times
Tuesday, October 30, 2012
Scientists Move Closer to a Long-Lasting Flu Vaccine
By CARL ZIMMER
As this year’s flu season gathers steam, doctors and pharmacists have a fresh stock of vaccines to offer their patients. The vaccines usually provide strong protection against the virus, but only for a while. Vaccines for other diseases typically work for years or decades. With the flu, though, next fall it will be time to get another dose.
“In the history of vaccinology, it’s the only one we update year to year,” said Gary J. Nabel, the director of the Vaccine Research Center at the National Institute of Allergy and Infectious Diseases.
That has been the case ever since the flu vaccine was introduced in the 1950s. But a flurry of recent studies on the virus has brought some hope for a change. Dr. Nabel and other flu experts foresee a time when seasonal flu shots are a thing of the past, replaced by long-lasting vaccines.
“That’s the goal: two shots when you’re young, and then boosters later in life. That’s where we’d like to go,” Dr. Nabel said. He predicted that scientists would reach that goal before long — “in our lifetime, for sure, unless you’re 90 years old,” he said.
Such a vaccine would be a great help in the fight against seasonal flu outbreaks, which kill an estimated 500,000 people a year. But in a review to be published in the journal Influenza and Other Respiratory Viruses, Sarah Gilbert of Oxford University argues that they could potentially have an even greater benefit.
Periodically, a radically new type of flu has evolved and rapidly spread around the world. A pandemic in 1918 is estimated to have killed 50 million people.
With current technology, scientists would not have a vaccine for a new pandemic strain until the outbreak was well under way. An effective universal flu vaccine would already be able to fight it.
“Universal vaccination with universal vaccines would put an end to the threat of global disaster that pandemic influenza can cause,” Dr. Gilbert wrote.
The New York Times
Tuesday, October 30, 2012
Scientists Move Closer to a Long-Lasting Flu Vaccine
By CARL ZIMMER
As this year’s flu season gathers steam, doctors and pharmacists have a fresh stock of vaccines to offer their patients. The vaccines usually provide strong protection against the virus, but only for a while. Vaccines for other diseases typically work for years or decades. With the flu, though, next fall it will be time to get another dose.
“In the history of vaccinology, it’s the only one we update year to year,” said Gary J. Nabel, the director of the Vaccine Research Center at the National Institute of Allergy and Infectious Diseases.
That has been the case ever since the flu vaccine was introduced in the 1950s. But a flurry of recent studies on the virus has brought some hope for a change. Dr. Nabel and other flu experts foresee a time when seasonal flu shots are a thing of the past, replaced by long-lasting vaccines.
“That’s the goal: two shots when you’re young, and then boosters later in life. That’s where we’d like to go,” Dr. Nabel said. He predicted that scientists would reach that goal before long — “in our lifetime, for sure, unless you’re 90 years old,” he said.
Such a vaccine would be a great help in the fight against seasonal flu outbreaks, which kill an estimated 500,000 people a year. But in a review to be published in the journal Influenza and Other Respiratory Viruses, Sarah Gilbert of Oxford University argues that they could potentially have an even greater benefit.
Periodically, a radically new type of flu has evolved and rapidly spread around the world. A pandemic in 1918 is estimated to have killed 50 million people.
With current technology, scientists would not have a vaccine for a new pandemic strain until the outbreak was well under way. An effective universal flu vaccine would already be able to fight it.
“Universal vaccination with universal vaccines would put an end to the threat of global disaster that pandemic influenza can cause,” Dr. Gilbert wrote.
For more, visit www.nytimes.com.
Monday, October 29, 2012
Massachusetts Shuts Down Another Compounder
The following is an excerpt from an article in:
The New York Times
Monday, October 29, 2012
Massachusetts Shuts Down Another Compounder
By ABBY GOODNOUGH
BOSTON — Massachusetts shut down another compounding pharmacy after a surprise inspection last week found conditions that called into question the sterility of its products, state officials said Sunday.
The pharmacy, Infusion Resource in Waltham, voluntarily surrendered its license over the weekend, said Dr. Madeleine Biondolillo, director of the Bureau of Health Care Safety and Quality at the Massachusetts Public Health Department. Inspectors who visited Infusion Resource on Tuesday found “significant issues with the environment in which medications were being compounded,” Dr. Biondolillo said during a news conference here. She would not disclose details, but said that in another troubling discovery, patients had apparently been receiving intravenous medications at the pharmacy, against state regulations.
The findings led the state to immediately issue a cease-and-desist order, Dr. Biondolillo said, preventing Infusion Resource from dispensing any drugs. But she added that as of yet, there was no evidence of any contaminated drugs produced there.
The latest shutdown comes amid a continuing investigation of New England Compounding Pharmacy, the company believed responsible for a national meningitis outbreak in which 25 people have died, at least 344 others have fallen ill and as many as 14,000 people are thought to have been exposed. State and federal inspections in recent weeks found unsanitary conditions at New England Compounding, from surfaces coated with mold and bacteria to residue on sterilization equipment.
New England Compounding has suspended operations and laid off most of its employees.
The New York Times
Monday, October 29, 2012
Massachusetts Shuts Down Another Compounder
By ABBY GOODNOUGH
BOSTON — Massachusetts shut down another compounding pharmacy after a surprise inspection last week found conditions that called into question the sterility of its products, state officials said Sunday.
The pharmacy, Infusion Resource in Waltham, voluntarily surrendered its license over the weekend, said Dr. Madeleine Biondolillo, director of the Bureau of Health Care Safety and Quality at the Massachusetts Public Health Department. Inspectors who visited Infusion Resource on Tuesday found “significant issues with the environment in which medications were being compounded,” Dr. Biondolillo said during a news conference here. She would not disclose details, but said that in another troubling discovery, patients had apparently been receiving intravenous medications at the pharmacy, against state regulations.
The findings led the state to immediately issue a cease-and-desist order, Dr. Biondolillo said, preventing Infusion Resource from dispensing any drugs. But she added that as of yet, there was no evidence of any contaminated drugs produced there.
The latest shutdown comes amid a continuing investigation of New England Compounding Pharmacy, the company believed responsible for a national meningitis outbreak in which 25 people have died, at least 344 others have fallen ill and as many as 14,000 people are thought to have been exposed. State and federal inspections in recent weeks found unsanitary conditions at New England Compounding, from surfaces coated with mold and bacteria to residue on sterilization equipment.
New England Compounding has suspended operations and laid off most of its employees.
For more, visit www.nytimes.com.
Saturday, October 27, 2012
Poor Sanitation Found at Pharmacy Linked to Meningitis Outbreak
The following is an excerpt from:
The New York Times
Saturday, October 27, 2012
Poor Sanitation Found at Pharmacy Linked to Meningitis Outbreak
By SABRINA TAVERNISE and ANDREW POLLACK
WASHINGTON — A federal inspection of a company whose tainted pain medicine has caused one of the worst public health drug disasters since the 1930s found greenish-yellow residue on sterilization equipment, surfaces coated with levels of mold and bacteria that exceeded the company’s own environmental limits, and an air-conditioner that was shut off nightly despite the importance of controlling temperature and humidity.
The findings, made public on Friday by the Food and Drug Administration, followed a report from Massachusetts regulators on Tuesday and offered disturbing new details in an emerging portrait of what went wrong inside the New England Compounding Center, the pharmacy at the heart of a national meningitis outbreak in which 25 people have died, 313 more have fallen ill and as many as 14,000 people are believed to have been exposed.
Instead of producing tailor-made drugs for individual patients, as the law allowed, the company turned into a major drug maker that supplied some of the most prestigious hospitals in the country, including ones affiliated with Harvard, Yale and the Mayo Clinic, all with minimal oversight from federal regulators.
Federal officials also drew attention to the company’s proximity to a recycling plant where excavators and freight trucks heaped old mattresses, plastics and other materials, generating large amounts of dust. The plant, which is owned by one of the same people as the pharmacy, has not always complied with regulations and has drawn complaints, according to records in Framingham, Mass., where the company is located.
And as the death toll continues to rise, the F.D.A.’s commissioner, Dr. Margaret Hamburg, who was appointed by President Obama, has stayed mostly silent.
Some observers said that weighing in loudly and publicly on a contentious issue was simply not Dr. Hamburg’s style. Others said that it was because the agency was preparing a criminal case and would not want to endanger that with statements construed to be prejudicial. David Kessler, a former F.D.A. commissioner, pointed to the impending presidential election and efforts to keep the outbreak from becoming a political issue.
The New York Times
Saturday, October 27, 2012
Poor Sanitation Found at Pharmacy Linked to Meningitis Outbreak
By SABRINA TAVERNISE and ANDREW POLLACK
WASHINGTON — A federal inspection of a company whose tainted pain medicine has caused one of the worst public health drug disasters since the 1930s found greenish-yellow residue on sterilization equipment, surfaces coated with levels of mold and bacteria that exceeded the company’s own environmental limits, and an air-conditioner that was shut off nightly despite the importance of controlling temperature and humidity.
The findings, made public on Friday by the Food and Drug Administration, followed a report from Massachusetts regulators on Tuesday and offered disturbing new details in an emerging portrait of what went wrong inside the New England Compounding Center, the pharmacy at the heart of a national meningitis outbreak in which 25 people have died, 313 more have fallen ill and as many as 14,000 people are believed to have been exposed.
Instead of producing tailor-made drugs for individual patients, as the law allowed, the company turned into a major drug maker that supplied some of the most prestigious hospitals in the country, including ones affiliated with Harvard, Yale and the Mayo Clinic, all with minimal oversight from federal regulators.
Federal officials also drew attention to the company’s proximity to a recycling plant where excavators and freight trucks heaped old mattresses, plastics and other materials, generating large amounts of dust. The plant, which is owned by one of the same people as the pharmacy, has not always complied with regulations and has drawn complaints, according to records in Framingham, Mass., where the company is located.
And as the death toll continues to rise, the F.D.A.’s commissioner, Dr. Margaret Hamburg, who was appointed by President Obama, has stayed mostly silent.
Some observers said that weighing in loudly and publicly on a contentious issue was simply not Dr. Hamburg’s style. Others said that it was because the agency was preparing a criminal case and would not want to endanger that with statements construed to be prejudicial. David Kessler, a former F.D.A. commissioner, pointed to the impending presidential election and efforts to keep the outbreak from becoming a political issue.
For more, visit www.nytimes.com.
Thursday, October 25, 2012
With Meningitis Outbreak, a Spotlight on Family Behind Compounding Pharmacy
The following is an excerpt from an article in:
The New York Times
Thursday, October 25, 2012
With Meningitis Outbreak, a Spotlight on Family Behind Compounding Pharmacy
By ABBY GOODNOUGH, SABRINA TAVERNISE and ANDREW POLLACK
A $4.2 million, four-bedroom Boston penthouse overlooking the Charles River in the Back Bay neighborhood. A $3.5 million home in Southborough, Mass., with more than 11,000 square feet, a home theater and an indoor saltwater pool. A $2.35 million vacation home on Cape Cod.
For the Conigliaro family of Massachusetts, owners of these properties, the past decade had been one of business success and rising personal prosperity.
Starting with a recycling company created by one brother in 1990, the family branched into pharmaceuticals, riding changes in the health care landscape to become a major supplier of tailor-made drugs to hospitals, clinics and doctor’s offices across the nation.
But those family enterprises are now under intense scrutiny by federal and state authorities and personal-injury lawyers. A pharmaceutical compounding company that is part of the family portfolio — the New England Compounding Center — was the source of a fungus that led to a meningitis outbreak that as of Wednesday had killed 24 and sickened 317.
Massachusetts officials said Tuesday that during an inspection this month investigators had found dirty mats and hoods, a leaky boiler, dark debris floating in vials of medicine, and evidence that the lab was not leaving enough time to properly sterilize some of its products.
Officials have pledged to revoke the licenses of Barry J. Cadden, a brother-in-law who was the head pharmacist at New England Compounding, and of the pharmacy itself. And production at the family’s larger pharmaceutical company, Ameridose, has been suspended and is also being investigated.
As the cases mount, the Conigliaros have stayed out of the public eye, speaking only through a longtime lawyer.
But the release of records by the Massachusetts Department of Public Health on Monday, as well as interviews with former employees of the drug companies, offer new details about the family and how the businesses operated.
Since the national outbreak began in September, most of the scrutiny has been focused on two founders of New England Compounding, Gregory Conigliaro, an entrepreneur who has run a major recycling operation for two decades, and Mr. Cadden, the pharmacist who married Mr. Conigliaro’s sister Lisa, also a pharmacist.
The New York Times
Thursday, October 25, 2012
With Meningitis Outbreak, a Spotlight on Family Behind Compounding Pharmacy
By ABBY GOODNOUGH, SABRINA TAVERNISE and ANDREW POLLACK
A $4.2 million, four-bedroom Boston penthouse overlooking the Charles River in the Back Bay neighborhood. A $3.5 million home in Southborough, Mass., with more than 11,000 square feet, a home theater and an indoor saltwater pool. A $2.35 million vacation home on Cape Cod.
For the Conigliaro family of Massachusetts, owners of these properties, the past decade had been one of business success and rising personal prosperity.
Starting with a recycling company created by one brother in 1990, the family branched into pharmaceuticals, riding changes in the health care landscape to become a major supplier of tailor-made drugs to hospitals, clinics and doctor’s offices across the nation.
But those family enterprises are now under intense scrutiny by federal and state authorities and personal-injury lawyers. A pharmaceutical compounding company that is part of the family portfolio — the New England Compounding Center — was the source of a fungus that led to a meningitis outbreak that as of Wednesday had killed 24 and sickened 317.
Massachusetts officials said Tuesday that during an inspection this month investigators had found dirty mats and hoods, a leaky boiler, dark debris floating in vials of medicine, and evidence that the lab was not leaving enough time to properly sterilize some of its products.
Officials have pledged to revoke the licenses of Barry J. Cadden, a brother-in-law who was the head pharmacist at New England Compounding, and of the pharmacy itself. And production at the family’s larger pharmaceutical company, Ameridose, has been suspended and is also being investigated.
As the cases mount, the Conigliaros have stayed out of the public eye, speaking only through a longtime lawyer.
But the release of records by the Massachusetts Department of Public Health on Monday, as well as interviews with former employees of the drug companies, offer new details about the family and how the businesses operated.
Since the national outbreak began in September, most of the scrutiny has been focused on two founders of New England Compounding, Gregory Conigliaro, an entrepreneur who has run a major recycling operation for two decades, and Mr. Cadden, the pharmacist who married Mr. Conigliaro’s sister Lisa, also a pharmacist.
For more, visit www.nytimes.com.
Wednesday, October 24, 2012
Sterility Found Lacking at Drug Site in Meningitis Outbreak
The following is an excerpt of an article in:
The New York Times
Wednesday, October 24, 2012
Sterility Found Lacking at Drug Site in Meningitis Outbreak
By ABBY GOODNOUGH
BOSTON — The compounding pharmacy blamed for a deadly national meningitis outbreak repeatedly failed to follow standard procedures to keep its facility clean and its products sterile, Massachusetts officials said Tuesday, painting a harrowing picture of a company that flouted crucial rules as it hurried to ship drugs around the country.
One finding in particular stands out: the pharmacy, the New England Compounding Center, shipped some orders of the drug implicated in the outbreak without waiting for the final results of sterility testing. And while company records indicate the tests found no contamination, regulators said they were skeptical of the company’s methods.
Records suggest that the company failed to sterilize products for “even the minimum amount of time necessary to ensure sterility,” said Dr. Madeleine Biondolillo, director of the Bureau of Health Care Safety and Quality at the Massachusetts Public Health Department.
The findings raise questions about whether the meningitis outbreak could have been averted, or reduced in magnitude, had proper procedures been followed.
“This was preventable,” said Eric S. Kastango, president of Clinical IQ, a consulting firm that counsels compounding pharmacies. “They failed to properly sterilize this medicine that had to be sterilized. That’s huge.”
Mats used to trap dust and dirt just outside the company’s clean rooms were “visibly soiled with assorted debris,” according to a report released Tuesday by the state’s Board of Registration in Pharmacy, and hoods in the sterile compounding area were not properly cleaned. A leaking boiler next to a clean room “created an environment susceptible to contaminant growth,” Dr. Biondolillo said during a news conference at the State House here.
Investigators are also looking into “the environmental conditions surrounding the business,” she said, including a recycling center on the same property in Framingham, Mass., and owned by the same family. At the same time, the state and the Food and Drug Administration are investigating two related drug companies, Ameridose of Westborough and Alaunus Pharmaceutical of Framingham, which have many of the same owners.
The New York Times
Wednesday, October 24, 2012
Sterility Found Lacking at Drug Site in Meningitis Outbreak
By ABBY GOODNOUGH
BOSTON — The compounding pharmacy blamed for a deadly national meningitis outbreak repeatedly failed to follow standard procedures to keep its facility clean and its products sterile, Massachusetts officials said Tuesday, painting a harrowing picture of a company that flouted crucial rules as it hurried to ship drugs around the country.
One finding in particular stands out: the pharmacy, the New England Compounding Center, shipped some orders of the drug implicated in the outbreak without waiting for the final results of sterility testing. And while company records indicate the tests found no contamination, regulators said they were skeptical of the company’s methods.
Records suggest that the company failed to sterilize products for “even the minimum amount of time necessary to ensure sterility,” said Dr. Madeleine Biondolillo, director of the Bureau of Health Care Safety and Quality at the Massachusetts Public Health Department.
The findings raise questions about whether the meningitis outbreak could have been averted, or reduced in magnitude, had proper procedures been followed.
“This was preventable,” said Eric S. Kastango, president of Clinical IQ, a consulting firm that counsels compounding pharmacies. “They failed to properly sterilize this medicine that had to be sterilized. That’s huge.”
Mats used to trap dust and dirt just outside the company’s clean rooms were “visibly soiled with assorted debris,” according to a report released Tuesday by the state’s Board of Registration in Pharmacy, and hoods in the sterile compounding area were not properly cleaned. A leaking boiler next to a clean room “created an environment susceptible to contaminant growth,” Dr. Biondolillo said during a news conference at the State House here.
Investigators are also looking into “the environmental conditions surrounding the business,” she said, including a recycling center on the same property in Framingham, Mass., and owned by the same family. At the same time, the state and the Food and Drug Administration are investigating two related drug companies, Ameridose of Westborough and Alaunus Pharmaceutical of Framingham, which have many of the same owners.
For more, visit www.nytimes.com.
Monday, October 22, 2012
Meningitis Exposure Patients Wait and Worry
The following is an excerpt from an article in:
The New York Times
Monday, October 22, 2012
Meningitis Exposure Patients Wait and Worry
By DENISE GRADY
Cathy Literski could tell something was wrong just from her mother’s voice on the telephone.
Her mother had learned that a steroid drug injected into her spine for back pain might have been contaminated with a fungus that could cause meningitis. Mrs. Literski had recently had the same type of injections herself, at the same pain clinic in Brighton, Mich. For a moment, neither woman could speak.
“I think we’re both terrified that the other one is going to come down with it,” Mrs. Literski, 57, said. “She’s worried sick about me, and I’m worried sick about her. She’s 80 years old, and if she were to come down with it, she would have very little chance of survival.”
It will be weeks, maybe even months, before the two women know if they are in the clear, past the incubation period for this type of meningitis, which can cause strokes.
About 14,000 people in the United States are in the same nerve-racking situation: knowing they might have been infected, waiting to see if they get sick. So far, 282 have contracted meningitis, and 23 have died, in a national outbreak linked to a contaminated drug made by the New England Compounding Center in Framingham, Mass. A few other patients have developed joint infections from having the drug, methylprednisolone, injected into knees, hips, shoulders or elbows.
Three lots of the drug, more than 17,000 vials, were shipped to 23 states. The meningitis and other infections are not contagious.
As the case count rises day by day, experts are racing to see if they can determine which patients among all those exposed are most likely to contract meningitis. If they can identify the high-risk patients, doctors can follow them intensively with spinal taps and other tests in hopes of detecting the disease and treating it early enough to prevent its dreadful complications.
As early as Monday, health officials may be able to offer doctors a method to estimate a patient’s risk and help decide how aggressive the follow-up should be, Dr. Marion Kainer of the Tennessee Health Department said on Friday during a telephone conference.
The New York Times
Monday, October 22, 2012
Meningitis Exposure Patients Wait and Worry
By DENISE GRADY
Cathy Literski could tell something was wrong just from her mother’s voice on the telephone.
Her mother had learned that a steroid drug injected into her spine for back pain might have been contaminated with a fungus that could cause meningitis. Mrs. Literski had recently had the same type of injections herself, at the same pain clinic in Brighton, Mich. For a moment, neither woman could speak.
“I think we’re both terrified that the other one is going to come down with it,” Mrs. Literski, 57, said. “She’s worried sick about me, and I’m worried sick about her. She’s 80 years old, and if she were to come down with it, she would have very little chance of survival.”
It will be weeks, maybe even months, before the two women know if they are in the clear, past the incubation period for this type of meningitis, which can cause strokes.
About 14,000 people in the United States are in the same nerve-racking situation: knowing they might have been infected, waiting to see if they get sick. So far, 282 have contracted meningitis, and 23 have died, in a national outbreak linked to a contaminated drug made by the New England Compounding Center in Framingham, Mass. A few other patients have developed joint infections from having the drug, methylprednisolone, injected into knees, hips, shoulders or elbows.
Three lots of the drug, more than 17,000 vials, were shipped to 23 states. The meningitis and other infections are not contagious.
As the case count rises day by day, experts are racing to see if they can determine which patients among all those exposed are most likely to contract meningitis. If they can identify the high-risk patients, doctors can follow them intensively with spinal taps and other tests in hopes of detecting the disease and treating it early enough to prevent its dreadful complications.
As early as Monday, health officials may be able to offer doctors a method to estimate a patient’s risk and help decide how aggressive the follow-up should be, Dr. Marion Kainer of the Tennessee Health Department said on Friday during a telephone conference.
For more, visit www.nytimes.com.
Saturday, October 20, 2012
David Quammen’s ‘Spillover’ Owes Much to Faulkner
The following is an excerpt from an article in:
The New York Times
Saturday, October 20, 2012
David Quammen’s ‘Spillover’ Owes Much to Faulkner
By CHARLES McGRATH
“Don’t have the monkey,” David Quammen said before lunch the other day at Casa Mono, a Catalan restaurant on Irving Place in Manhattan. “Or if you do, order it medium-well.”
There was a haunch of some strange salted and air-cured mammal on the bar, but despite the restaurant’s name (Casa Mono means Monkey House in Spanish), there is no monkey on the menu, and a good thing too. As Mr. Quammen points out in his scary but hard-to-put-down new book, “Spillover: Animal Infections and the Next Human Pandemic,” eating tainted chimpanzee meat is a good way to come down with the Ebola virus.
Ebola is just one of many horrific diseases that turn up in “Spillover.” Some of the others are SARS, AIDS, bubonic plague, Lyme disease, West Nile fever, Marburg virus, swine flu, bird flu and Hendra virus, or horse measles. What they have in common is that they are all zoonoses — animal infections that jump over into humans — and the book’s unsettling thesis is that such crossovers are bound to happen with more frequency, and possibly greater virulence, as people increasingly encroach on formerly wild and undisturbed habitats.
“We’re shaking loose viruses and dislodging them from their natural ecological limitations, places where they aren’t very abundant and have competition, even within a single animal,” Mr. Quammen said. “We introduce them into a new, rich habitat called the human population, where they can flourish more abundantly and cause more trouble.”
Mr. Quammen, who is 64 but looks much younger, grew up in Cincinnati but has lived for the last 40 years in Montana. He is wiry and tanned, and though Dwight Garner, reviewing “Spillover” in The Times, called him “not just among our best science writers but among our best writers, period,” you could easily mistake him for a fishing guide or a field biologist. “Spillover,” which took Mr. Quammen some 12 years to write, has chapters on virology, scientific history, even on math, but in most of the book he is not just in the lab or the library but also in remote locations all over Central Africa, Malaysia and China. He loves arduous travel, he said over lunch, and he enjoys the company of adventurous scientists.
In the book some of them become as vivid as characters in a Michael Crichton scientific thriller, or as obsessed as the questers in a Rider Haggard novel, only in search of pathogens instead of buried treasure.
The New York Times
Saturday, October 20, 2012
David Quammen’s ‘Spillover’ Owes Much to Faulkner
By CHARLES McGRATH
“Don’t have the monkey,” David Quammen said before lunch the other day at Casa Mono, a Catalan restaurant on Irving Place in Manhattan. “Or if you do, order it medium-well.”
There was a haunch of some strange salted and air-cured mammal on the bar, but despite the restaurant’s name (Casa Mono means Monkey House in Spanish), there is no monkey on the menu, and a good thing too. As Mr. Quammen points out in his scary but hard-to-put-down new book, “Spillover: Animal Infections and the Next Human Pandemic,” eating tainted chimpanzee meat is a good way to come down with the Ebola virus.
Ebola is just one of many horrific diseases that turn up in “Spillover.” Some of the others are SARS, AIDS, bubonic plague, Lyme disease, West Nile fever, Marburg virus, swine flu, bird flu and Hendra virus, or horse measles. What they have in common is that they are all zoonoses — animal infections that jump over into humans — and the book’s unsettling thesis is that such crossovers are bound to happen with more frequency, and possibly greater virulence, as people increasingly encroach on formerly wild and undisturbed habitats.
“We’re shaking loose viruses and dislodging them from their natural ecological limitations, places where they aren’t very abundant and have competition, even within a single animal,” Mr. Quammen said. “We introduce them into a new, rich habitat called the human population, where they can flourish more abundantly and cause more trouble.”
Mr. Quammen, who is 64 but looks much younger, grew up in Cincinnati but has lived for the last 40 years in Montana. He is wiry and tanned, and though Dwight Garner, reviewing “Spillover” in The Times, called him “not just among our best science writers but among our best writers, period,” you could easily mistake him for a fishing guide or a field biologist. “Spillover,” which took Mr. Quammen some 12 years to write, has chapters on virology, scientific history, even on math, but in most of the book he is not just in the lab or the library but also in remote locations all over Central Africa, Malaysia and China. He loves arduous travel, he said over lunch, and he enjoys the company of adventurous scientists.
In the book some of them become as vivid as characters in a Michael Crichton scientific thriller, or as obsessed as the questers in a Rider Haggard novel, only in search of pathogens instead of buried treasure.
For more, visit www.nytimes.com.
Thursday, October 18, 2012
Tuesday, October 16, 2012
Wider Meningitis Risk From Tainted Drugs Feared
The following is an excerpt from an article in:
The New York Times
Tuesday, October 16, 2012
Wider Meningitis Risk From Tainted Drugs Feared
By DENISE GRADY and SABRINA TAVERNISE
Health officials are warning that more people may be at risk from contaminated drugs made by a Massachusetts company linked to a growing meningitis outbreak.
The Food and Drug Administration reported on Monday that the company’s products may have also caused other types of infections in patients who have had eye operations or open-heart surgery.
The new warning is based on only two cases, and it was not known for sure whether the company’s drugs had caused the infections. Officials did not say how many people may be at risk, but the number is potentially significant, and a statement from the agency warned doctors, “The F.D.A. recognizes that some health care professionals may receive a high volume of calls from patients or be concerned about having to notify many patients as a result of today’s announcement.”
The company, the New England Compounding Center in Framingham, Mass., has already been linked to a meningitis outbreak that has killed 15 patients and infected 199 others in 15 states. The drug implicated in that outbreak is methylprednisolone acetate, a steroid used in spinal injections for back and neck pain. The drug is believed to have been contaminated with a fungus called Exserohilum, which causes a type of meningitis that is severe but not contagious.
Now, several other drugs made by the company are also possible suspects in infections. A heart-transplant patient exposed to a product that is used during open-heart surgery developed a chest infection with a different fungus, Aspergillus, the Food and Drug Adminstration said. The product is a cardioplegic solution, which is chilled and poured into the opened chest to stop the heart while surgeons work on it. Such solutions have caused problems in the past, according to the F.D.A., which reported that it issued a warning letter in 2006 to a firm that had produced a solution that caused fatal infections in three heart-surgery patients.
The agency emphasized that the heart case was still being investigated, and that it was possible that the infection had come from a source other than the cardioplegic solution. A second heart-surgery patient who had an Aspergillus infection and was initially reported to have received a solution made by the New England Compounding Center had been treated with solution made by another company.
The New York Times
Tuesday, October 16, 2012
Wider Meningitis Risk From Tainted Drugs Feared
By DENISE GRADY and SABRINA TAVERNISE
Health officials are warning that more people may be at risk from contaminated drugs made by a Massachusetts company linked to a growing meningitis outbreak.
The Food and Drug Administration reported on Monday that the company’s products may have also caused other types of infections in patients who have had eye operations or open-heart surgery.
The new warning is based on only two cases, and it was not known for sure whether the company’s drugs had caused the infections. Officials did not say how many people may be at risk, but the number is potentially significant, and a statement from the agency warned doctors, “The F.D.A. recognizes that some health care professionals may receive a high volume of calls from patients or be concerned about having to notify many patients as a result of today’s announcement.”
The company, the New England Compounding Center in Framingham, Mass., has already been linked to a meningitis outbreak that has killed 15 patients and infected 199 others in 15 states. The drug implicated in that outbreak is methylprednisolone acetate, a steroid used in spinal injections for back and neck pain. The drug is believed to have been contaminated with a fungus called Exserohilum, which causes a type of meningitis that is severe but not contagious.
Now, several other drugs made by the company are also possible suspects in infections. A heart-transplant patient exposed to a product that is used during open-heart surgery developed a chest infection with a different fungus, Aspergillus, the Food and Drug Adminstration said. The product is a cardioplegic solution, which is chilled and poured into the opened chest to stop the heart while surgeons work on it. Such solutions have caused problems in the past, according to the F.D.A., which reported that it issued a warning letter in 2006 to a firm that had produced a solution that caused fatal infections in three heart-surgery patients.
The agency emphasized that the heart case was still being investigated, and that it was possible that the infection had come from a source other than the cardioplegic solution. A second heart-surgery patient who had an Aspergillus infection and was initially reported to have received a solution made by the New England Compounding Center had been treated with solution made by another company.
For more, visit www.nytimes.com
Monday, October 15, 2012
HPV Vaccine Does Not Alter Sexual Behavior, Study Finds
The following is an excerpt from an article in:
The New York Times
Monday, October 15, 2012
HPV Vaccine Does Not Alter Sexual Behavior, Study Finds
By ANAHAD O'CONNOR
Coni Butler, an accountant in Austin, Tex., and a devout Catholic, encourages her three children to remain celibate before marriage. But that did not stop her from getting them vaccinated against human papillomavirus, or HPV, a sexually transmitted disease that raises the risk of some cancers.
Ms. Butler had her son and two daughters vaccinated between ages 12 and 15. She was not deterred by widespread concerns that the vaccine might encourage promiscuity.
"We talk about remaining chaste until they get married, but there's always the possibility that one bad choice could lead to devastating consequences," she said. "I tell my friends that you pray for the best, but you plan for the worst."
Since public health officials began recommending in 2006 that young women be routinely vaccinated against HPV, many parents have hesitated over fears that doing so might give their children license to have sex. But research published on Monday in the journal Pediatrics may help ease those fears.
Looking at a sample of nearly 1,400 girls, the researchers found no evidence that those who were vaccinated beginning around age 11 went on to engage in more sexual activity than girls who were not vaccinated.
"We're hopeful that once physicians see this, it will give them evidence that they can give to parents," said Robert A. Bednarczyk, the lead author of the report and a clinical investigator with the Kaiser Permanente Center for Health Research Southeast, in Atlanta. "Hopefully when parents see this, it'll be reassuring to them and we can start to overcome this barrier."
The New York Times
Monday, October 15, 2012
HPV Vaccine Does Not Alter Sexual Behavior, Study Finds
By ANAHAD O'CONNOR
Coni Butler, an accountant in Austin, Tex., and a devout Catholic, encourages her three children to remain celibate before marriage. But that did not stop her from getting them vaccinated against human papillomavirus, or HPV, a sexually transmitted disease that raises the risk of some cancers.
Ms. Butler had her son and two daughters vaccinated between ages 12 and 15. She was not deterred by widespread concerns that the vaccine might encourage promiscuity.
"We talk about remaining chaste until they get married, but there's always the possibility that one bad choice could lead to devastating consequences," she said. "I tell my friends that you pray for the best, but you plan for the worst."
Since public health officials began recommending in 2006 that young women be routinely vaccinated against HPV, many parents have hesitated over fears that doing so might give their children license to have sex. But research published on Monday in the journal Pediatrics may help ease those fears.
Looking at a sample of nearly 1,400 girls, the researchers found no evidence that those who were vaccinated beginning around age 11 went on to engage in more sexual activity than girls who were not vaccinated.
"We're hopeful that once physicians see this, it will give them evidence that they can give to parents," said Robert A. Bednarczyk, the lead author of the report and a clinical investigator with the Kaiser Permanente Center for Health Research Southeast, in Atlanta. "Hopefully when parents see this, it'll be reassuring to them and we can start to overcome this barrier."
For more, visit www.nytimes.com.
Saturday, October 13, 2012
Workers Cite Concerns at Firms Tied to Meningitis
The following is an excerpt from an article in:
The New York Times
Saturday, October 13, 2012
Workers Cite Concerns at Firms Tied to Meningitis
By SABRINA TAVERNISE and ANDREW POLLACK
BOSTON — One pharmacist said she quit because she was worried that unqualified people were helping prepare dangerous narcotics for use by hospitals. A quality control technician said he tried to stop the production line when he noticed that some labels were missing, but was overruled by management. A salesman said he and his colleagues were brought into the sterile lab to help out with packaging and labeling during rush orders, something they were not trained for.
They all used to work at Ameridose, a drug manufacturing company with many of the same owners as the New England Compounding Center, the pharmacy at the center of a national investigation into a meningitis outbreak now in 12 states.
State and federal health officials say they have no reason to believe that Ameridose sent out contaminated products, and have not recalled any. But regulators asked the company on Wednesday to suspend production to allow them to conduct an on-site investigation, because their inquiry “includes concerns for quality and safety across the corporate entity,” the Massachusetts Department of Public Health said.
Paul Cirel, a lawyer representing Ameridose, declined to discuss the statements made by the former employees. “What some anonymous, maybe disgruntled, ex-employees say to you that is not said to us by the F.D.A. or any regulator, I just can’t go there right now,” he said. “If it becomes a claim that a regulator puts to us, then we will address it.”
Mr. Cirel, of Boston-based Collora L.L.P., added that the suspension was voluntary and would be in place until Oct. 22.
In all, eight former employees were interviewed, three from New England Compounding and five from Ameridose. Three of those former workers said the companies were run with good attention to safety.
Thomas DiAdamo, who was a salesman for New England Compounding for about two years, said, “When I heard about this I was shocked, because they were meticulous about safety.”
He said Barry Cadden, New England Compounding’s chief pharmacist, who is also a shareholder in Ameridose and who lost his pharmacist license this week, told him, “ ‘We do not make mistakes.’ Something must have happened that was out of his control.”
The New York Times
Saturday, October 13, 2012
Workers Cite Concerns at Firms Tied to Meningitis
By SABRINA TAVERNISE and ANDREW POLLACK
BOSTON — One pharmacist said she quit because she was worried that unqualified people were helping prepare dangerous narcotics for use by hospitals. A quality control technician said he tried to stop the production line when he noticed that some labels were missing, but was overruled by management. A salesman said he and his colleagues were brought into the sterile lab to help out with packaging and labeling during rush orders, something they were not trained for.
They all used to work at Ameridose, a drug manufacturing company with many of the same owners as the New England Compounding Center, the pharmacy at the center of a national investigation into a meningitis outbreak now in 12 states.
State and federal health officials say they have no reason to believe that Ameridose sent out contaminated products, and have not recalled any. But regulators asked the company on Wednesday to suspend production to allow them to conduct an on-site investigation, because their inquiry “includes concerns for quality and safety across the corporate entity,” the Massachusetts Department of Public Health said.
Paul Cirel, a lawyer representing Ameridose, declined to discuss the statements made by the former employees. “What some anonymous, maybe disgruntled, ex-employees say to you that is not said to us by the F.D.A. or any regulator, I just can’t go there right now,” he said. “If it becomes a claim that a regulator puts to us, then we will address it.”
Mr. Cirel, of Boston-based Collora L.L.P., added that the suspension was voluntary and would be in place until Oct. 22.
In all, eight former employees were interviewed, three from New England Compounding and five from Ameridose. Three of those former workers said the companies were run with good attention to safety.
Thomas DiAdamo, who was a salesman for New England Compounding for about two years, said, “When I heard about this I was shocked, because they were meticulous about safety.”
He said Barry Cadden, New England Compounding’s chief pharmacist, who is also a shareholder in Ameridose and who lost his pharmacist license this week, told him, “ ‘We do not make mistakes.’ Something must have happened that was out of his control.”
For more, visit www.nytimes.com.
Sunday, October 7, 2012
Scant Drug Maker Oversight in Meningitis Outbreak
The following is an excerpt from an article in:
The New York Times
Sunday, October 07, 2012
Scant Drug Maker Oversight in Meningitis Outbreak
By DENISE GRADY, ANDREW POLLACK and SABRINA TAVERNISE
Eddie C. Lovelace, a Kentucky judge still on the bench into his late 70s, had a penchant for reciting Shakespeare from memory and telling funny stories in his big, booming voice. But a car accident last spring left him with severe neck pain, and in July and August he sought spinal injections with a steroid medicine for relief.
Instead, Judge Lovelace died in Nashville in September at age 78, one of the first victims in a growing national outbreak of meningitis caused by the very medicine that was supposed to help him. Health officials say they believe it was contaminated with a fungus.
The rising toll — 7 dead, 57 ill and thousands potentially exposed — has cast a harsh light on the loose regulations that legal experts say allowed a company to sell 17,676 vials of an unsafe drug to pain clinics in 23 states. Federal health officials said Friday that all patients injected with the steroid drug made by that company, the New England Compounding Center in Framingham, Mass., which has a troubled history, needed to be tracked down immediately and informed of the danger.
“This wasn’t some obscure procedure being done in some obscure hospital,” said Tom Carroll, a close friend to the Lovelace family, and their lawyer. “They had sought out a respected neurosurgeon who had been referred by their family doctor, at a respected hospital,” he said, referring to the St. Thomas Outpatient Neurosurgery Center. “How does this happen?”
The answer, at least in part, is that some doctors and clinics have turned away from major drug manufacturers and have taken their business to so-called compounding pharmacies, like New England Compounding, which mix up batches of drugs on their own, often for much lower prices than major manufacturers charge — and with little of the federal oversight of drug safety and quality that is routine for the big companies.
“The Food and Drug Administration has more regulatory authority over a drug factory in China than over a compounding pharmacy in Massachusetts,” said Kevin Outterson, an associate professor of law at Boston University.
The outbreak has also brought new scrutiny to the widely used procedure that Judge Lovelace and millions of Americans undergo each year.
Patients most likely assumed there was strong evidence that the procedure itself works. But the Cochrane Collaboration, an international group of medical experts, reviewed the data last year and found there was “no strong evidence for or against” the injections. Patients exposed to the drug in the current outbreak may have risked their health or even their lives for an elusive goal.
The New York Times
Sunday, October 07, 2012
Scant Drug Maker Oversight in Meningitis Outbreak
By DENISE GRADY, ANDREW POLLACK and SABRINA TAVERNISE
Eddie C. Lovelace, a Kentucky judge still on the bench into his late 70s, had a penchant for reciting Shakespeare from memory and telling funny stories in his big, booming voice. But a car accident last spring left him with severe neck pain, and in July and August he sought spinal injections with a steroid medicine for relief.
Instead, Judge Lovelace died in Nashville in September at age 78, one of the first victims in a growing national outbreak of meningitis caused by the very medicine that was supposed to help him. Health officials say they believe it was contaminated with a fungus.
The rising toll — 7 dead, 57 ill and thousands potentially exposed — has cast a harsh light on the loose regulations that legal experts say allowed a company to sell 17,676 vials of an unsafe drug to pain clinics in 23 states. Federal health officials said Friday that all patients injected with the steroid drug made by that company, the New England Compounding Center in Framingham, Mass., which has a troubled history, needed to be tracked down immediately and informed of the danger.
“This wasn’t some obscure procedure being done in some obscure hospital,” said Tom Carroll, a close friend to the Lovelace family, and their lawyer. “They had sought out a respected neurosurgeon who had been referred by their family doctor, at a respected hospital,” he said, referring to the St. Thomas Outpatient Neurosurgery Center. “How does this happen?”
The answer, at least in part, is that some doctors and clinics have turned away from major drug manufacturers and have taken their business to so-called compounding pharmacies, like New England Compounding, which mix up batches of drugs on their own, often for much lower prices than major manufacturers charge — and with little of the federal oversight of drug safety and quality that is routine for the big companies.
“The Food and Drug Administration has more regulatory authority over a drug factory in China than over a compounding pharmacy in Massachusetts,” said Kevin Outterson, an associate professor of law at Boston University.
The outbreak has also brought new scrutiny to the widely used procedure that Judge Lovelace and millions of Americans undergo each year.
Patients most likely assumed there was strong evidence that the procedure itself works. But the Cochrane Collaboration, an international group of medical experts, reviewed the data last year and found there was “no strong evidence for or against” the injections. Patients exposed to the drug in the current outbreak may have risked their health or even their lives for an elusive goal.
For more, visit www.nytimes.com.
Thursday, October 4, 2012
Wednesday, October 3, 2012
‘Spillover,’ by David Quammen, on How Animals Infect Humans
The following is an excerpt from a book review in the New York Times:
The New York Times
Wednesday, October 03, 2012
‘Spillover,’ by David Quammen, on How Animals Infect Humans
By DWIGHT GARNER
SPILLOVER
Animal Infections and the Next Human Pandemic
By David Quammen
587 pages. W. W. Norton & Company. $28.95.
Linguists have a good eye for where language has been, but it’s rarely easy to see into its future. In his powerful and discomfiting new book, “Spillover: Animal Infections and the Next Human Pandemic,” the science writer David Quammen cites a dismal word we’ll be getting used to in the coming decades, whether we like it or not: zoonosis.
A zoonosis in an animal infection that, through a simple twist of fate, becomes transmissible to humans. Maybe that twist is a needle prick, or contact with an exotic animal or hiking downwind of the wrong farm.
“It’s a mildly technical term,” he admits, but probably not for long. “It’s a word of the future, destined for heavy use in the 21st century.”
Ebola and bubonic plague are zoonoses. So are, he writes, in a list that peals off the tongue like a distraught Allen Ginsberg poem or an outstanding list of death metal band names, “monkeypox, bovine tuberculosis, Lyme disease, West Nile fever, Marburg virus disease, rabies, hantavirus pulmonary syndrome, anthrax, Lassa fever, Rift Valley fever, ocular larva migrans, scrub typhus, Bolivian hemorrhagic fever, Kyasanur forest disease, and a strange new affliction called Nipah encephalitis, which has killed pigs and pig farmers in Malaysia.”
AIDS, he adds, that destroyer of 30 million people, is of zoonotic origin.
In “Spillover” Mr. Quammen investigates many of these diseases, some more than others. He describes the baffled horror of initial outbreaks and then tracks calmly backward. He talks to virologists, doctors, field biologists and survivors about how the animal-to-human infection came to pass. He hopscotches the globe like a journalistic Jason Bourne. Often there aren’t doctors left to be interviewed. The medical personnel who first came into contact with sick patients are frequently dead.
Among these diseases, the devils we know are bad enough. Mr. Quammen also thinks determinedly about what he calls the NBO’s — the Next Big Ones. “Will the Next Big One come out of a rain forest or a market in southern China?” he asks. “Will the Next Big One kill” 30 million or 40 million people? He makes you dread that sneeze at the back of the bus.
The New York Times
Wednesday, October 03, 2012
‘Spillover,’ by David Quammen, on How Animals Infect Humans
By DWIGHT GARNER
SPILLOVER
Animal Infections and the Next Human Pandemic
By David Quammen
587 pages. W. W. Norton & Company. $28.95.
Linguists have a good eye for where language has been, but it’s rarely easy to see into its future. In his powerful and discomfiting new book, “Spillover: Animal Infections and the Next Human Pandemic,” the science writer David Quammen cites a dismal word we’ll be getting used to in the coming decades, whether we like it or not: zoonosis.
A zoonosis in an animal infection that, through a simple twist of fate, becomes transmissible to humans. Maybe that twist is a needle prick, or contact with an exotic animal or hiking downwind of the wrong farm.
“It’s a mildly technical term,” he admits, but probably not for long. “It’s a word of the future, destined for heavy use in the 21st century.”
Ebola and bubonic plague are zoonoses. So are, he writes, in a list that peals off the tongue like a distraught Allen Ginsberg poem or an outstanding list of death metal band names, “monkeypox, bovine tuberculosis, Lyme disease, West Nile fever, Marburg virus disease, rabies, hantavirus pulmonary syndrome, anthrax, Lassa fever, Rift Valley fever, ocular larva migrans, scrub typhus, Bolivian hemorrhagic fever, Kyasanur forest disease, and a strange new affliction called Nipah encephalitis, which has killed pigs and pig farmers in Malaysia.”
AIDS, he adds, that destroyer of 30 million people, is of zoonotic origin.
In “Spillover” Mr. Quammen investigates many of these diseases, some more than others. He describes the baffled horror of initial outbreaks and then tracks calmly backward. He talks to virologists, doctors, field biologists and survivors about how the animal-to-human infection came to pass. He hopscotches the globe like a journalistic Jason Bourne. Often there aren’t doctors left to be interviewed. The medical personnel who first came into contact with sick patients are frequently dead.
Among these diseases, the devils we know are bad enough. Mr. Quammen also thinks determinedly about what he calls the NBO’s — the Next Big Ones. “Will the Next Big One come out of a rain forest or a market in southern China?” he asks. “Will the Next Big One kill” 30 million or 40 million people? He makes you dread that sneeze at the back of the bus.
For more, visit www.nytimes.com.
Meningitis Cases Are Linked to Steroid Injections
The following is an excerpt from an article in:
The New York Times
Wednesday, October 03, 2012
Meningitis Cases Are Linked to Steroid Injections
By DENISE GRADY
Dr. April Pettit, an infectious diseases specialist at Vanderbilt University, was worried about her patient. He had been ill with meningitis for two weeks, he was not getting better, and she could not figure out why. Antibiotics, the usual treatment, were not helping. Bacteria, the usual suspects, could not be found.
On the morning of Sept. 18, as she and a colleague were examining the patient and talking to his family, a pager buzzed. It was the hospital lab, with an answer at last — but a troubling one.
A culture of the patient’s spinal fluid had revealed a fungus, Aspergillus. The patient was so ill that he could no longer communicate, so Dr. Pettit spoke to the family.
“I told them it was a very unusual cause of meningitis in healthy people, and that we needed to try to figure out how he got this infection,” she said.
Had he done anything unusual in the weeks before he became ill? she asked. The answer alarmed her. He had had a steroid injection in his spinal area to relieve back pain — a common treatment, administered to millions of people in the United States every year.
Dr. Pettit called the State Health Department.
She is now credited with being the clinician who recognized the “index case” in what has become a frightening outbreak of meningitis that has killed two people and sickened 12 others who also received steroid injections in their spines for pain. Doctors suspect that the steroid medicine was contaminated with the fungus. The meningitis does not spread from person to person.
Officials said it was not possible to predict the extent of the outbreak yet. Thirteen of the patients have been in Tennessee, and one in North Carolina. Two of the cases were new as of Tuesday, and health officials have said that there could be more cases and that other states could be affected.
The New York Times
Wednesday, October 03, 2012
Meningitis Cases Are Linked to Steroid Injections
By DENISE GRADY
Dr. April Pettit, an infectious diseases specialist at Vanderbilt University, was worried about her patient. He had been ill with meningitis for two weeks, he was not getting better, and she could not figure out why. Antibiotics, the usual treatment, were not helping. Bacteria, the usual suspects, could not be found.
On the morning of Sept. 18, as she and a colleague were examining the patient and talking to his family, a pager buzzed. It was the hospital lab, with an answer at last — but a troubling one.
A culture of the patient’s spinal fluid had revealed a fungus, Aspergillus. The patient was so ill that he could no longer communicate, so Dr. Pettit spoke to the family.
“I told them it was a very unusual cause of meningitis in healthy people, and that we needed to try to figure out how he got this infection,” she said.
Had he done anything unusual in the weeks before he became ill? she asked. The answer alarmed her. He had had a steroid injection in his spinal area to relieve back pain — a common treatment, administered to millions of people in the United States every year.
Dr. Pettit called the State Health Department.
She is now credited with being the clinician who recognized the “index case” in what has become a frightening outbreak of meningitis that has killed two people and sickened 12 others who also received steroid injections in their spines for pain. Doctors suspect that the steroid medicine was contaminated with the fungus. The meningitis does not spread from person to person.
Officials said it was not possible to predict the extent of the outbreak yet. Thirteen of the patients have been in Tennessee, and one in North Carolina. Two of the cases were new as of Tuesday, and health officials have said that there could be more cases and that other states could be affected.
For more, visit www.nytimes.com.
Monday, October 1, 2012
http://www.nih.gov/researchmatters/october2012/10012012antibiotic.htm
Received Oct. 1, 2012
Early Antibiotic Use May Affect Weight
http://www.nih.gov/researchmatters/october2012/10012012antibiotic.htm
Early Antibiotic Use May Affect Weight
For full article, click the link below:
http://www.nih.gov/researchmatters/october2012/10012012antibiotic.htm
New expedited article now online
Received Oct 1, 2012.
Subclinical Influenza Virus A Infections in Pigs Exhibited at Agricultural Fairs, Ohio, USA, 2009–2011
New expedited article now online
Subclinical Influenza Virus A Infections in Pigs Exhibited at Agricultural Fairs, Ohio, USA, 2009–2011
For full article, click the link below:
New expedited article now online
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