Health Headlines - August 1

North Dakota Hospital Adds Meditation Room

Sherman Iron Shield used to sneak his son behind some elevators at St. Alexius Medical Center so he could burn sacred herbs to chase away evil spirits without setting off the hospital's fire alarms and sprinklers.

He believes the practice, known as smudging, along with modern medicine, helped his son, George, recover from a gunshot wound to the head nearly a dozen years ago. Now he and other members of the region's large American Indian population can follow their traditions without worrying about the fire alarms.

On Thursday, the Roman Catholic hospital dedicated a $350,000 solarium and meditation room that may be used for such things as burning sage, cedar or sweetgrass, and for singing or drumming.

Tex Hall, chairman of North Dakota's Three Affiliated Tribes and president of the National Congress of American Indians, said smudging is allowed in Indian Health Service hospitals and clinics on reservations, but generally not outside the reservations.

"I think this is the first of its kind in a privately owned hospital," Hall said of the St. Alexius meditation room. "It's a long time coming and a tremendous step forward for native people. I think we'll see much better healing and recovery."

A spokeswoman for the American Hospital Association in Washington said she did not know of any other hospital with such a room. But Amy Lee said some may have rooms generally set aside for non-Christian patients.

"Hospitals are definitely working toward accommodating growing multiculturalism," Lee said.

The number of American Indian admissions at St. Alexius hospital increased 79 percent from 1998 to 2002, when about 5,760 of the 72,000 patients were Indians, said marketing director Nancy Willis. Many were from the Standing Rock Sioux reservation, which straddles the line between North Dakota and South Dakota.

The meditation room, 12 feet by 20 feet, is intended for people of non-Christian faiths, or those "for whom the main chapel is not suitable," said Sister Renee Zastoupil, the hospital's director of pastoral programs.

John Eagle Shield, a member of the Standing Rock Sioux tribe, helped push to get the meditation room at the hospital so American Indians could practice their sacred traditions.

"We have had a lot of tribal people come here in the past who have said they were the victims of misunderstanding," Eagle Shield said. "A lot of people were reluctant to come here."

The room also features a window situated so Muslims can pray toward Mecca. Syed Hassan, a physician at St. Alexius, said he and the dozen or so other Muslim doctors at the hospital use the room for daily prayer.

"We are all children of God," Hassan told the crowd of about 200 people at the dedication ceremony on Thursday. "We are more similar than otherwise."

The hospital has published rules for use of the room. Peyote, used by some American Indian groups in ceremonies, and other drugs are prohibited, as is the "practice of any religion or act which is diametrically opposed to the Roman Catholic Church." The hospital lists "Satanism, Wicca and Voodoo" as examples.

The meditation room has an exhaust system to suck out smoke from seashell bowls of burning sage, cedar and sweetgrass, and it is soundproofed to hush singing and drumming.

Eagle Shield said "traditional healers" can use the room to work with patients.

"The traditional healing will compliment Western healing, so we can get the best of both worlds," he said.

China educates farmers on pig-borne disease

Sichuan province in southwestern China has launched a campaign to educate poor, illiterate farmers not to slaughter sick pigs or eat their meat after an outbreak of swine flu hit about 100 villages and killed at least 34 people.

Sichuan, the country's top pork-producing province, has been forced to suspend all exports of chilled and frozen pork from Ziyang city and surrounding Neijiang prefecture to Hong Kong, where there have been 10 infections since 2004.

China's Ministry of Health said 174 people had been infected by the disease, 28 of them in critical condition.

More than 2 million notices have been issued in affected areas informing farmers of the dangers, the China Daily reported on Saturday, quoting a vice mayor of Ziyang, situated near the provincial capital, Chengdu.

About 50,000 health workers and officials have been sent to the areas to inspect and register every pig, and authorities have set up 39 temporary roadside quarantine stations to stop dead pigs from reaching markets.

"It's having a big effect ... In Sichuan, no one is buying meat or slaughtering hogs," Xie Hong of the animal feed company Southern Hope Co., part of the New Hope Group, told Reuters.

Pork is China's favorite meat and the country consumes more of it than anywhere else in the world. Of 618 million pigs slaughtered in 2004, Sichuan accounted for about 14 percent.

Authorities say victims were suffering from Streptococcus suis bacteria, or swine flu, an infection contracted from slaughtering, handling or eating infected pigs.

The disease, first reported in Neijiang, has spread to Chengdu itself and four other Sichuan cities. One case has been reported in the southern province of Guangdong near Hong Kong.

Two factories have resumed production of a vaccine used years ago to control previous outbreaks of swine flu.

Health officials in Sichuan and Beijing have been tight-lipped about the outbreak, which was discovered on June 24.

STUBBORN FARMERS

Most low-income farmers insist on slaughtering sick pigs and eating the meat themselves instead of burying the carcasses with heavy disinfectant at their own expense, the China Daily said.

"If animals die from some unknown disease, most farmers deal with the carcass themselves and then eat the meat," it said. "Many farmers became sick after eating suspect pork."

An official at the China Center for Disease Control and Prevention blamed the outbreak on unsanitary conditions at Sichuan's small-scale pig farms combined with a heatwave.

One victim, Li Haiqing, 55, lives in a single-storey house in Guashi village with 15 pigs, two of which have died, confined to a damp, dark and smelly sty across from his bedroom.

Wang Xingcheng, 55, a farmer in Renli village, developed a fever and lost hearing after eating infected pork. His brother who handled dead pigs had a fever for a few days while other members of the family remained healthy.

Many small-scale slaughter houses operate illegally and elude inspection checks. Such pork is sold to underground processors.

"No one likes to bother the local epidemic prevention station," one local veterinarian was quoted as saying.

Beijing has banned pig and pork imports from Sichuan and set up checkpoints on roads leading to the capital to block diseased pork and avert a health threat to its 15 million residents.

Swine flu is endemic in most pig-rearing countries but human infections are rare. Although China's state media have said no human-to-human infections had been found in Sichuan, the death toll is considered unusually high.

Swine flu is not known ever to have been passed between humans, but scientists fear it could mutate into a bug that could easily pass among people, unleashing a deadly epidemic.

China Bans Media From Covering Outbreak

Chinese authorities have banned local reporters from visiting areas where an outbreak of a pig-borne disease has killed 34 farmers, ordering newspapers to use dispatches from the state news agency, a Hong Kong newspaper reported Sunday.

A total of 174 confirmed or suspected cases have been linked to the bacteria streptococcus suis in China's southwestern Sichuan province, where farmers who handled or butchered infected pigs have been sickened in dozens of villages and towns. Symptoms include nausea, fever, vomiting, and bleeding under the skin.

Sichuan authorities have ordered local journalists to stay away from locations where the disease surfaced, and told newspapers to instead carry stories as issued by the official Xinhua News Agency, including the headline, Hong Kong's Ming Pao Daily News reported.

Calls to Sichuan's provincial government headquarters in Chengdu seeking confirmation of the media ban went unanswered.

Beijing was heavily criticized during its SARS outbreak for its reluctance to release information. A Sichuan journalist, quoted by the Ming Pao newspaper, said Hong Kong reporters were better informed than they were about the pig disease.

Former British colony Hong Kong, which returned to Chinese rule in 1997, isn't subject to China's media controls under a special autonomy arrangement. Much of the information about the disease has been filtering out through Hong Kong, which is briefed by China about health threats.

Hong Kong is wary about diseases spreading here from China, especially after severe acute respiratory syndrome killed 299 people in the territory in 2003 and devastated the economy.

The first cases of the pig-borne disease outbreak appeared in the city of Ziyang and elsewhere in Sichuan. The first case outside the province was reported Saturday in Guangdong, a southern Chinese province neighboring Hong Kong. Hong Kong has also reported 11 cases of the disease since May 2004, but it wasn't clear if they were related to the Sichuan outbreak.

New Tick Killers Avoid Widespread Spraying

After her husband got Lyme disease, her young son kept getting tick bites in their yard and a close friend nearly died of the tick-borne infection, Laurie Gaulke felt she had to do something. With heavy brush and a forest with deer behind her home in Gillette, Gaulke tried a new strategy three years ago: installing a tick-killing system in the brush fringing her yard.

Bait inside the plastic boxes lures rodents that harbor the bacteria causing Lyme disease. A wick coats their fur with a chemical that kills ticks for up to six weeks. New boxes must be installed by trained pest control contractors each spring and summer.

Developed by the Centers for Disease Control and Prevention, the Maxforce Tick Management System is one of a few new alternatives to widespread chemical spraying to kill ticks and prevent Lyme disease, which can cause long-term health problems and cost thousands of dollars to cure.

Another new device that targets tick hosts is called the 4-Poster Deer Treatment Bait Station, a tick-killing chemical that must be replenished weekly along with a type of corn deer like but eat only in small amounts. It was invented by the U.S. Department of Agriculture.

Experts on Lyme disease and tick control say consumers should seek data on the effectiveness of both systems before making a purchase.

Gaulke, whose family is often outside, said Maxforce began sharply reducing tick numbers after a year.

"It's not like I'm spraying something toxic ... that I have to worry about my child or my dog playing in," she said.

Maxforce and 4-Poster, two methods that directly target animals on which ticks feed, can take a couple years to reach peak effectiveness, so insecticide should be applied a few times in areas harboring ticks, pesticide contractors say.

However, a government survey found 75 percent of the public won't use a spray, said CDC senior research biologist Marc Dolan. Tick populations are extremely high in the Northeast this year, and moving west, he noted.

A quarter century after Lyme disease was named for the Connecticut town where it was first observed, it has spread to all but nine states with the exploding U.S. population of deer, the primary hosts on which black-legged deer ticks feed.

Mice, chipmunks and occasionally other rodents -- but not deer -— harbor the bacteria causing Lyme disease, and infect ticks that later bite people and pets.

According to the CDC, 21,273 cases of Lyme disease were reported in 2003, mostly in New England and mid-Atlantic states. CDC estimates only 10 percent of cases are reported because Lyme disease often causes only mild, flu-like symptoms.

Symptoms can also include fever, fatigue, joint and muscle aches, headache and, in some people, a bull's eye rash. Untreated, it can cause neurological problems, personality changes, sleep disturbances, disabling joint pain and swelling, meningitis or heart problems.

Dolan, who helped develop Maxforce and tested it on tick-infested Mason's Island off Connecticut, said it has cut the number of ticks by 80 percent to 95 percent after two years.

Montvale-based Bayer Environmental Science launched Maxforce under a CDC license last year and now sells it in 18 states and Washington, D.C. Prices run from a few hundred dollars to $1,000 per year, depending on property size and amount of brush.

The 4-Poster device was licensed to the American Lyme Disease Foundation, which gets a small royalty on sales, and to manufacturer C.R. Daniels Inc. of Ellicott City, Md.

J. Allen Miller, a supervisory research engineer with USDA's Agricultural Research Service, said a study in five Northeast states found 4-Poster killed 70 percent to 90 percent of ticks in two years.

"It's not spread over the environment," Miller said, and spraying uses about 1,500 times as much insecticide as the 4-Poster system.

The feeder costs $425, plus $175 for a year's worth of the tick-killing chemical.

Durland Fish, science adviser to the foundation, said it endorses the 4-poster system, though it needs improvements. One drawback is that it cannot be used near homes because children could touch the exposed chemical.

The foundation also backs Maxforce and two other products. Those are the Buzz Off shirt sold by Orvis, which claims an embedded, natural insect repellent drives off ticks, mosquitoes and other insects through 25 washings, and the Snap 3Dx Test, which lets veterinarians quickly test dogs for Lyme and other tick-borne diseases — a sign family members may be infected.

Fish says other strategies are in development, including a fungi spray safer than other pesticides, a Lyme disease vaccine for mice and use of nematodes, tiny worms that eat ticks.

Immunologist Dr. Steven Schutzer of University of Medicine and Dentistry of New Jersey in Newark, who has done research on tick habitats, said infected patients seem to be seeking help sooner, when antibiotics are most effective. He said few patients follow the "long sleeves, long pants tucked in" strategy to avoid tick bites, so people should avoid areas with ankle-deep brush where ticks and mice are likely to be.

Doctors Track Separated Twins' Progress

One year after a neurosurgeon separated them by cutting through a section of brain, Carl Aguirre says "Wow!" as he whizzes a toy truck off the tray of his high chair and his brother Clarence holds his nose to let his mother know his diaper is dirty.

After "starting their life over," the formerly conjoined 3-year-old Filipino boys have been amazingly free of significant complications, doctors say. Clarence is about to take his first steps and therapists say Carl will soon follow.

"When they emerged from the OR as separate boys, it was almost as if that was their second birth," said Dr. Robert Marion, the boys' pediatrician. "Their motor skills are what you'd expect of a 1-year-old. They're starting to walk. They're playing appropriately in the way that a 1-year-old would. Their speech, also, is like that of a 1-year-old."

Until last Aug. 4, when they underwent the fourth in a series of major operations at the Children's Hospital at Montefiore Medical Center in the Bronx, Carl and Clarence had been unable to sit up, stand straight or see each other's face. Joined at the top of their heads, they were limited to lying on their backs, which stunted their development and subjected them to chronic pneumonia caused by inhaling food.

"They were going to die," Marion said. "And now seeing them with unlimited potential, it's the most gratifying experience I've ever had in medicine."

The boys and their mother, Arlene, came to New York in 2003, when Montefiore agreed to take the boys' case for free -- it has cost more than $3 million so far -- and the Blythedale Children's Hospital in Valhalla agreed to donate housing and therapy.

The Children's Hospital team of neurosurgeon Dr. James Goodrich and plastic surgeon Dr. David Staffenberg separated the boys in a gradual "staged" approach, pushing apart their brains and dividing the blood vessels in four operations from October 2003 to August 2004. In between, the boys were given time to heal. It was a departure from the more common single marathon operation.

During the final operation, the surgeons found that the boys' brains, which scans had indicated were abutting but separate, were actually shared and seamless at one point. Dreading whatever complications he might cause, Goodrich studied and consulted and finally found a place to cut where veins seemed to go in opposite directions.

"I am not a religious person," Goodrich said last week. "But I do think there was something guiding us along there."

Marion said Carl suffered some seizures in the month after the separation, but Goodrich said his principal fears -- neurological problems and liquid on the brain -- did not develop.

During a reporter's recent visit to Blythedale, Clarence walked proudly, holding onto a therapist with one hand and pushing his stroller with the other. He was so energetic that at one point he stepped out of his pants and staffers had to find him a belt.

Meanwhile, Carl stood, a bit unsteadily, to play a bead game on a table.

Later, the boys laughed as they tumbled down a padded slide together. Though their skulls have not yet been reconstructed -- doctors don't want to interrupt their therapy -- and specially designed plastic helmets haven't fit well, the doctors say the boys' heads are protected well enough by their bandages even for horseplay.

Arlene Aguirre tried to hide while she watched her sons' therapy session, because when they see her the boys want to do nothing but cuddle.

"Both of them want my attention all the time," she said. "But it's very exciting that I have to deal with two children. ... Before the separation, I was thinking: `Will I ever see them again?'"

She said she is encouraged when she hears Clarence say "yogurt" and call his brother by name. Carl says "walk" and "mama" and both boys use sign language to convey such phrases as "please more eat."

Aguirre said she expects to move from Blythedale soon and set up a household with the boys, and hopes to eventually return to the Philippines.

"My friends and family, I want to share the boys with them," she said. "It will be so exciting to go back there, holding one boy with each hand."

The success of the operation has brought honors for Goodrich and Staffenberg, although Goodrich says the best prize he's received is a Montefiore parking space. They are constantly invited to speak or write about the procedure, which has been published in journals for neurosurgery, plastic surgery and anesthesia.

The surgeons recommend their "staged" approach not just for conjoined twins but for other severe craniofacial cases. In the only separation of similar "craniopagus" twins in the U.S. since the Aguirre boys, surgeons at Johns Hopkins used the marathon approach on 1-year-old German girls and only one survived.

Goodrich said an upcoming procedure overseas -- he wouldn't say where -- will be performed their way.

He said he initially tried to keep an emotional distance from the boys, but confessed "you can't go through something like we did and not get attached. You can't be around them and not love them."

Staffenberg said he recently came up behind Clarence, who was walking down a hallway while holding a therapist's hand.

"Clarence turned around and looked at me and put his other hand out for me," Staffenberg said. "I don't think at any point during all the surgery I would have imagined that kind of situation. When you get the moment when they reach out for your hand, it's unbelievable."

Staying Away From West Nile Virus

With West Nile virus now present in all 48 contiguous states, avoiding infection has become a seasonal concern for nearly all Americans.

The virus, which made its U.S. debut in New York City in 1999, is spread by mosquitoes that pick it up when feeding on infected birds and animals. Humans, in turn, contract the virus when bitten by infected mosquitoes. High season is primarily late summer or early fall.

A relatively small proportion of people infected -- about one in 200 -- will become seriously ill with West Nile encephalitis, the potentially fatal swelling of the brain that is the virus's most serious effect. Another 20 in 200 will experience less severe flu-like symptoms, including fever, headache and fatigue.

Individuals over the age of 50 and those with weakened immune systems are the most vulnerable to serious illnesses. In the first U.S. outbreak in 1999, 55 people in New York City were hospitalized and seven died, most of them elderly.

The best thing Americans can do is avoid getting bitten. Here are some prevention tips:

* Eliminate places where mosquitoes might breed. This often means water sitting in buckets, toys, flower pots, and discarded tires.
* Unclog roof gutters on an annual basis.
* Turn over plastic wading pools, wheelbarrows, and birdbaths when not in use.
* Before going outside, cover yourself with insect repellant containing 20 percent to 30 percent DEET for adults and no more than 10 percent for children over the age of 3. Apply the repellant only to exposed skin and clothing.
* Wear long-sleeved shirts and pants if you're going outside for longer periods of time.

Quadriplegic Coughs With Help of Implant

Just five weeks ago, Ronnie Moore could not do what most people take for granted -— cough and clear his lungs. Now Moore, a quadriplegic, coughs by simply pressing a button on a control box on the tray of his wheelchair.

"I feel air moving out of my throat," said Moore, who is in his 50s.

Moore's cough was the first performed electronically by a quadriplegic, according to his doctor, Anthony DiMarco, a research scientist at MetroHealth Medical Center in Cleveland.

Not being able to cough made Moore susceptible to respiratory infections like bronchitis and pneumonia -— a leading cause of hospitalization and death in paraplegics and quadriplegics. He also was not able to clear his throat of food or secretions without help from an attendant at the nursing home where he lives.

Moore, paralyzed from the neck down in a 1998 car accident, is the first patient to participate in a four-year, $1.5 million study paid for by the National Institutes of Health. DiMarco says three other quadriplegics are scheduled to receive the implants in September.

Five weeks ago, three electrodes the size of pencil erasers were implanted near the surface of Moore's spine to activate the nerves emanating from his lower spinal cord. The electrodes are connected by wires to a small receiver implanted under his skin, just below his rib cage.

A small external battery pack attached to the receiver activates the electrodes to contract his abdominal muscles, causing them to generate a cough.

DiMarco said it will take at least three more weeks to determine how much electrical current is needed to give Moore consistent, strong coughs.

"This will make him more like a normal person who can cough anytime he wants to," the doctor said.

Young Athletes Warned of Asthma's Dangers

For kids and teens, summer is peak time for outdoor fun, whether it be on the gridiron, the basketball court, the track or in the pool. But for young people with poorly controlled asthma, sports can be a dangerous game.

In fact, a study last year by doctors at St. Christopher's Hospital for Children in Philadelphia counted 61 U.S. deaths over the past decade linked to sudden asthma attacks during sporting events -- most involving victims between 10 and 20 years of age.

"There is nothing more horrifying than seeing a young athlete running and dying on the sports field," said Dr. Jack M. Becker, author of the study, which appeared in the February 2004 Journal of Allergy and Clinical Immunology, and chief of allergy and asthma at St. Christopher's.

Such deaths are rare considering how many young athletes have asthma -- as many as 6 percent to 18 percent, according to Becker. But they highlight a crucial issue for asthmatic children and their physicians, parents and coaches: awareness and control of asthma, not just asthma attacks. That means chronic therapy to keep respiratory symptoms under control at all times.

Most of the fatalities in his study involved "mild asthmatics who were not on chronic therapy," Becker pointed out. "Rarely does someone have a severe attack for the first time," he said.

According to the American Academy of Allergy, Asthma & Immunology, over 5 million American children have asthma, which is caused by a swelling and closing of the airways, usually in response to specific triggers such as pollen, mold and cigarette smoke. Exercise can also trigger asthma attacks, as can exposure to cold air. Symptoms include coughing, wheezing, shortness of breath, and chest pain or tightness.

If immediate treatment is not available, a severe asthma attack can be fatal.

In the study, Becker's team combed through news reports for suspected cases of sports-related asthma deaths occurring over the previous seven-and-a-half years.

They report that white males between the ages of 10 and 20 were at highest risk, with deaths for whites outnumbering blacks two-to-one. Boys were twice as likely to die from asthma during sports than girls.

Basketball and track made up the bulk of fatalities, although asthma claimed the lives of those engaged in football, swimming, cheerleading and other athletic activities. "Any aerobic sport can do it," Becker said.

A player's physical prowess didn't seem to protect him or her, either, the study found. In fact, those who played professionally or on a school team were more at risk of asthma-related death than those who played recreationally.

The issue gained national attention four years ago when Northwestern University football player Rashidi Wheeler collapsed during a preseason workout and died soon after. His death was blamed on bronchial asthma.

Early recognition of asthma and effective, chronic control may be key to reducing sports-related deaths, Becker said. "If we don't treat this disease early we can affect their entire lives," Becker said.

Asthma control means "maintenance therapy" -- medication that's taken chronically, even when asthma symptoms aren't there.

"There are two components to asthma treatment, rescue medication and maintenance medication," explained Dr. Michael Light, director of clinical service in pediatric pulmonary at the University of Miami Medical School. Of the two, maintenance therapy, also called controlling therapy, is far trickier to comply with, even though it is the most effective way to stay symptom-free.

"The problem is that when you feel well, you don't stay on the medication," he said.

People also get used to their symptoms, such as a tight chest or coughing during the night, he said. Too often, they assume these troubles are simply part of the disease -- something they have to live with. In fact, medications are available to treat these symptoms.

Adolescents are even less likely to stick to maintenance therapy, Light noted, because of their natural tendency to rebel against authority. "We haven't found a good way to get them to comply," he said.

Becker said the best way to increase compliance is to spread the word to the adult community about the importance of treating asthma before problems occur. Working with an advocacy group called Coalition of Health for Asthmatics in Sports & Exercise (CHASE), he lectures several times a month to school groups, teachers and other physicians about the importance of treating asthma properly so that children can participate in sports.

There's certainly no need to think kids with asthma can't take to the field, gym or pool, he said.

"The news is that you can play sports at a high level and still have asthma if you work with physicians, coaches and parents to make sure you're well-controlled," Becker said.

Some simple precautions can help asthmatic kids have all the (safe) fun they want this summer:

* Make sure the child's rescue inhaler is nearby at all times.
* Keep asthma under control. If a child is up all night coughing and wheezing, sending him or her off to the playing field the next morning isn't a good idea.
* If a child uses rescue medication once just before a game and then again once during the game, fine. If they require it a third time, that's a sign they need to be withdrawn from play.

Winning against asthma is the real championship play, Becker said. "I tell people that you need to be on top of your asthma if you want to play the best you can."

Kidney Stone Danger Heats Up in Summer

Summer's heat is high time for kidney stones, experts warn.

While there are many causes of kidney stones and they can affect anyone at any time of the year, they are most common during the summer.

That's because hot weather, combined with heavy sweating and not drinking enough water, can cause people to become dehydrated. That can result in increased concentrations of substances in the urine. Those substances then crystallize to form kidney stones, says the American Foundation for Urologic Disease (AFUD).

People who work outdoors in hot weather and don't drink enough fluids may increase their risk of developing kidney stones, the AFUD says.

Drinking sufficient fluids may help prevent kidney stones. The Kidney Foundation of Canada suggests you drink a glass of water every hour during the day and whenever you get up during the night. Be sure to drink enough after you exercise and eat.

Of course, dehydration isn't the only cause of kidney stones. Other causes include: infections or blockages of the urinary tract; bed rest or inactivity for several weeks or more; too much calcium oxalate, uric acid, or vitamin C or D in your diet; some medications; and certain metabolic diseases.

Kidney stones vary in composition, and there are different ways you can prevent them. The Kidney Foundation of Canada offers the following tips:

* If you have calcium oxate stones, avoid consuming large amounts of dairy products or foods with a high oxalate content. Examples of those are tea and chocolate.
* Don't take large doses (four grams or more each day) of vitamin C and don't use a lot of antacids.
* If you suffer with uric acid kidney stones, you can cut down the amount of red meat you eat.

Angola immunizes 5 million children in polio fight

Angola stepped up its fight against polio on Sunday, with mothers out in force to take advantage of a nationwide immunization drive after the first appearance of the disease in the African country in four years.

The three-day, $3.74 million campaign, which ends on Sunday, was run by the Health Ministry, the United Nations Childrens Fund UNICEF and the World Health Organization (WHO) and is aimed at stopping polio before it spreads.

Angola this month identified three new cases of the disease -- two in the capital Luanda and one in the western province of Benguela -- the first such cases since 2001.

The diagnoses, along with a new outbreak of polio in Indonesia, were a setback to the WHO which has campaigned to stop the global spread of polio by the year's end.

In northern Bengo, a rural province which borders Luanda, health workers and parents were on high alert as medical staff in four-wheel drive vehicles traveled to the far corners of the region armed with oral polio vaccines.

"These two cases in Luanda have made us very concerned because Luanda is our neighbor, it is very close to us," said Zhenzo Makonda-Mbuta, head of Bengo's public health department. "Polio is very contagious. We don't want it here, so we need to react to make a barrier."

REMOTE AREAS

Angola's national routine immunization coverage is just 45 percent, with coverage in remote areas particularly patchy as the health network struggles to rebuild following the end of 27 years of civil war.

The national offensive enlisted 12,500 teams to go house-to-house and visit markets and churches to make sure the vaccines reached the targeted five million children.

But news of the return of polio, a highly-infectious disease which affects mainly the under-fives and can cause total paralysis in hours, had traveled fast. Most mothers were lining up to get their children immunized.

"We heard about the new cases on the radio so we are very happy that these teams are coming here," said Lucia, whose 10-month-old daughter was vaccinated as they shopped in Bengo's capital Caxito. "Every mother fears the return of polio and wants to protect her child."

In Luanda and Benguela, the campaign focused on stamping out the type-1 strain of polio, believed to have entered Angola from India.

"We imported very quickly a monovalent oral polio vaccine which is 90 percent effective in targeting this strain of the virus and was used only in areas where we have seen cases," said Mario Ferrari, UNICEF's representative in Angola.

Elsewhere, the teams used a trivalent vaccine which produces antibodies to all three strains of the virus.

Ferrari said the partners were mulling a third national immunization round after a second already planned for the end of August. Several doses of vaccine are needed to fully protect a child from polio.

Polio is the latest health scare to hit Angola, which earlier this year fought an outbreak of the rare Ebola-like Marburg fever which claimed more than 300 lives.

Food Fact:
"Pea" is for Protein.

Can eating peas save your eyesight? Peas are also an excellent source of lutein, which is believed to help fight macular degeneration, the leading cause of blindness in people age 65 and older. It may surprise you to learn peas are not vegetables -- they're actually legumes. Either way, a 2/3-cup serving contains about 5 grams of protein, or about 10% of the daily protein needs of a 130-lb. person. Like other legumes, peas are rich in B vitamins, minerals and soluble fiber. While it's a treat to eat fresh peas in late spring and early summer, shucking them is tedious. Frozen peas are just as nutritious as fresh. Add them to pilafs, bean salads and soups.

Fitness Tip of the day:
Don't be a night owl.

Exercising just before bedtime may be asking for trouble. Aerobic exercise -- and exercise in general -- helps you fall asleep more quickly and sleep longer, but generally not if you if you work out just before turning in. Don't be tempted by your gym's late hours if you have to get up early the next morning; most of us need a few hours to relax and decompress after a workout before going to sleep, so you might pay a price the next day.

FAQ of the day:
Are there different diets for diabetics?

There are different diets for controlling type 1 and type 2 diabetes. The basic dietary principles for any healthy diet apply to both types of diabetes, but the top priorities are different. In Type 1 diabetes, which requires insulin injections, it's most critical to match the amount of food you eat at each meal and snack with your injection schedule. For Type 2 diabetes, the top priority usually is limiting overall calories to lose weight; meal-to-meal variations are less critical.