Tighter Surveillance Of Swine Flu In Pigs Needed Worldwide Says CDC

The US Centers for Disease Control and Prevention (CDC) said that there is a "global need for more systemic surveillance of influenza viruses in pigs", during a press briefing where they explained the findings of a recent study on the genetic and antigenetic properties of the new 2009 H1N1 swine flu virus.

The CDC led study was published online in the journal Science on 22 May and was the work of human and animal health scientists from the US, Mexico, the UK and the Netherlands.

According to the CDC, the study is the first to explain the history and evolution of the human and swine influenza viruses in North America and other areas of the world, as deduced from the detailed analysis of the antigenic and genetic characteristics of the new H1N1 viruses.

In a press briefing on Friday, senior author Dr. Nancy Cox, who is director of the CDC's influenza division said that the study reinforced the fact that:

"Swine are an important reservoir of influenza viruses with the potential to cause significant respiratory outbreaks or even a possible pandemic in humans."

Cox praised the "excellent collaboration" that went into the study, and stressed the importance of the global co-operation that will be needed to fight the new H1N1 strain, for example by rapidly collecting and sharing specimens, without which it is not possible to understand the origin of the virus and how to stop it spreading and re-emerging.

For the study, the researchers sequenced the genomes of more than 70 samples of the new H1N1 taken from human patients diagnosed with the infection in the recent outbreaks, including 17 viruses isolated in Mexico and 59 viruses from 12 states in the United States.

The analysis showed that the new H1N1 virus likely originated in pigs because each of its genetic components closely corresponds to genes found in swine flu viruses, said Cox, who then highlighted the study's main findings:

• The new H1N1 viruses are very alike in the way they react to antibodies, that is their antigenetic properties are similar. However, in this respect they are very different to human H1N1 viruses (like the seasonal flu virus), so this indicates that the seasonal flu vaccine will probably not protect against the new virus, a fact that the CDC announced last week.


• The fact the new H1N1 strains are very similar means that it will be much easier to come up with a new candidate virus for vaccine development (there are already reports that a lab has sent a sample candidate virus to the CDC). Cox said as far as they could tell, the new H1N1 swine flu viruses varied much less among themselves than say the typical seasonal flu viruses do.


• From their resistance patterns it appears that the new H1N1 viruses are sensitive to the neuraminidase inhibitors, but resistant to the M2 blockers or rimantidine (Flumadine) and amantadine (Symmetrel). This is important information for the development and use of antivirals.


• As revealed in previous press briefings, the new virus also contained clusters of gene segments that had not been seen in swine or human flu viruses before. A noticeable new feature was that two gene segments, one from a matrix protein and the other from a nerve gene, seemed to have come from Eurasian swine viruses not seen outside of Eurasia before.


• While the analysis shows that all gene segments came from swine flu viruses, it was not possible to say if the virus then went straight into humans or via an intermediate host, and if it did go via a host, then which animal that would be.


• Animal scientists all over the world, including colleagues from the US Department of Agriculture (USDA) are testing samples they have kept frozen for years to see if they can provide any missing links to this part of the puzzle. For instance, there might be intermediate versions of the virus that could help narrow down the time and place where the new virus emerged.

When asked if these findings mean that pig surveillance will now be as important as avian surveillance as far as flu virus monitoring was concerned, Dr. Anne Schuchat, director of CDC's national center for immunization and respiratory diseases, said:

"This really hits home how important it is for animal and human health to cooperate and collaborate."

She said she and her colleagues at the CDC were very pleased at how the collaboration between animal and human health has improved, implying it was vital to continue this because as the past few decades have shown, "the animal-human interface is very important".

Taken from MedicalNewsToday

Restricting Access To Patient Records Will Damage Patient Care, Say Top Researchers

Moves to restrict researchers' access to patient record data will undermine patient care, say top researchers in an article published by the medical journal Pulse. Heads of some of the UK's top research organizations warn that over-protectiveness over the safety of public data will result in UK patients not having access to clinical trials treatments.

The UK government has dropped a key pledge to grant researchers the right in the NHS constitution to access identifiable medical records without needing to get patient consent - this was after an uproar among General Practitioners (GPs).

In order to select clinical trial participants, the researchers say it is essential to be able to access patient data without having to seek consent first. The researchers suggest safe havens be set up so they might access anonymous patient data.

Sir Mark Walport, director of the Wellcome Trust - said the NHS Constitution was "going in the right direction" but Government was dithering over allowing access to anonymous patient data. "It is becoming harder and harder to do research that was previously easy to do. If you actually explain to patients about how their data is going to be used, then they are happy for it to be used."

Sir Mark says the argument is being distorted by concern over high profile data leaks from government agencies "None of these were related to medical research - not one," he said.

Professor Peter Weissberg, Medical Director, British Heart Foundation, said patients could gain access to "gold standard" treatment in clinical trials, but this was being jeopardized by Government moves to curb access to medical records.

Weissberg added "We run the risk of unpicking everything that we have done before, and we may not be able to do landmark studies such as the Heart Protection Study in this country."

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What Is Mesothelioma? Lung Cancer From Asbestos

Mesothelioma is a form of lung cancer that is almost always caused by asbestos exposure and is most commonly found in the outer lining of the lungs called the mesothelium. A majority of the people who develop mesothelioma contract this cancer through breathing in asbestos fibers or being exposed to asbestos dust while on the job. In cases where mesothelioma is found in a person with no previous occupational exposure, it is summarized that the exposure may have stemmed from asbestos fibers found on the clothes of someone in their home who worked in an area where asbestos dust was found.

There are a number of reasons that make diagnosing mesothelioma in its early stages extremely difficult. The symptoms of mesothelioma can have a latency period of anywhere between 20 to 50 years after the initial asbestos contact, which means by the time the symptoms begin to show, the cancer is already within its advanced stages. Once symptoms are present, diagnosis is still not a speedy process. There are a number of diseases that mirror the symptoms that are found in mesothelioma patients and because of this mesothelioma is often the last stop - usually without prior mention from the patient about the possibility of previous asbestos exposure.

The success of treatment for mesothelioma is dependent on the stage in which the cancer is found. As it is found that most mesothelioma is not discovered until the advanced stages, mesothelioma treatment is often referred to as "unsuccessful." Studies show that when found within either stage I or II, treatment for mesothelioma - usually with a combination of radiation and chemotherapy - is successful in extending the patient's life for five years at a rate of 74.6% (Wikipedia). There are also alternative forms of therapy that can be used in conjunction with conventional treatments, that have been shown on occasion to decrease the size of mesothelioma found in a patient.

Asbestos was used for many years in a wide array of household and industrial products because of its multiple types and uses. It is fireproof, and can also be used as an insulator, thus allowing it to become very popular during the Industrial Revolution. It is unknown whether or not people were aware of the dangers of asbestos fibers at that time, but by the 1900's the risk of asbestos was becoming more obvious. People who lived in mining towns would develop lung problems, and general studies showed that asbestos workers died at a young age. Asbestos, in an undisturbed state, seems to pose no threat. However, as soon as it becomes damaged or friable, the fibers are able to be ingested, thus potentially leading to these or other health problems. Although some companies were aware of this danger, they continued to work with products containing asbestos with no regard to their employees. These blatant injustices are the reason for the popularity of mesothelioma in the field of litigation.

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Increased Suicide Risk On Young Men Leaving The UK Armed Forces

A new study in this week´s PLoS Medicine, reports that the risk of suicide increases two to three time on young men 24 years old or less who leave the UK Armed Forces than those remaining in active service or those in the general population.

In the first two years after discharge, the risk seems to increase in the men with short length of service, and those of inferior rank. Just 14 percent of 20 years old or less and 20 percent of 24 years old or under, had communication with mental health specialists in the year prior to their death, according to the study.

Nav Kapur, Center for Suicide Prevention, University of Manchester, UK, and his team, conducted a cohort study, using data from the National Confidential Inquiry into Suicide and Homicide in connection to all the people who left the UK Armed Forces between 1996 and 2005. The Inquiry, since 1996, has been gathering data on all the suicides in the UK, as well as whether the deceased had contact with mental health services in the year prior to death. Of the 233,803 individuals who left the Armed Forces, 224 committed suicide, during the study period.

The overall suicide rate of the ex-military personnel was comparable to that of the general population, according to the study. Although the absolute risk of suicide is small (in 16 to 19 years old, the rate of suicide was of 29.9 per 100,000 persons and in 20 to 24 years old, 34.0 per 100,000 persons), the rate was higher for younger men.

The cause for the higher risk in young men was not established in the study but researchers point out three key potential elements: -Anxiety due to transition to civilian life -Experience of difficult circumstances while in the military -Vulnerability to suicide prior to enrolling in the military According to the study, there is some proof to confirm the third possibility, since inexpert recruits leaving the military after short lengths of service were at highest risk of suicide. The increased risk may reveal a pre-military weakness.

Kapur and his team suggest suicide prevention strategies should be targeted to young people leaving the military. They say these might incorporate "practical and psychological preparation for discharge and encouraging appropriate help-seeking behavior once individuals have left the services".

Jitender Sareen and Shay-Lee Belik, University of Manitoba, Winipeg Canada, who are both unrelated to the study, underline in an expert commentary, the example of the US Air Force which has a suicide program for the exposed military population. They also reflect on suicide prevention in general public health.

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Northeastern University Professor Studies Limited Literacy And Mental Health Outcomes

Alisa Lincoln, Ph.D., M.P.H., associate professor of health sciences and sociology at Northeastern, recently completed one of the first studies of its kind on the role of literacy and mental health. While much attention has been focused on the role of literacy and health, little is known about the relationship between literacy and mental health. This study was designed to assess the literacy level of people seeking treatment for a full range of psychiatric disorders with the hopes of better understanding the relationship between literacy and mental health outcomes.

The results were published in the Journal of Nervous and Mental Disease.

According to the National Institutes of Health, an estimated 26.2 percent of Americans ages 18 and older - about one in four adults - suffer from a diagnosable mental disorder in a given year. In addition, millions of Americans lack the literacy proficiency necessary to understand and act on health information from health care providers.

"Although mental health issues and limited literacy are very common in the United States, there is little information about how one impacts the other," said Lincoln.

Literacy impacts health outcomes, and limited literacy creates unique challenges in mental health treatment. Current standard psychiatric evaluations do not include a literacy assessment, and many treatment methods assume a certain level of literacy, creating barriers to positive health outcomes for patients with a psychiatric diagnosis.

Professor Lincoln and her colleagues conducted this study in an urban public health clinic with patients diagnosed with a wide range of psychiatric diagnoses, including depression, bipolar disorder, anxiety, substance abuse, attention deficit hyperactivity disorder and schizophrenia.

"Most of the current information about mental health and literacy focuses only on depression," said Lincoln. "We wanted to expand on that and look at other diagnoses to examine how literacy levels vary among different diagnoses."

This study was done in collaboration with Dr. Peggy Johnson, Vice Chair of Clinical Psychiatry at Boston Medical Center.

The data collected showed that a complicated relationship exists between literacy and the aforementioned psychiatric diagnoses. There exists a correlation between limited literacy in some diagnoses, but it was not consistent.

"In order to develop effective psychiatric treatments that result in better outcomes, we need to increase our understanding of the relationships that exist between psychiatric disorders - on all levels - and health literacy," added Lincoln. "It is important for clinicians to take literacy levels into consideration when developing treatment plans for their patients."

For more information about Professor Lincoln's research, please visit http://www.northeastern.edu/bouve/faculty/lincoln_a.html


Taken from medicalnewstoday.com with permission