Friday, January 09, 2009

Health Headlines - January 9

Racial, Ethnic Disparities Persist in Spina Bifida Births

Public health efforts to decrease the number of babies born with spina bifida should target women at higher risk, including those who are obese, of Hispanic ethnicity, or who carry certain genetic risk factors, according to a new review by the U.S. Centers for Disease Control and Prevention (CDC).

Spina bifida, a developmental birth defect of the neural tube, called an NTD-affected pregnancy, results in an infant's having an incompletely formed spinal cord. In January 1998, the U.S. Food and Drug Administration mandated adding folic acid to all enriched cereal grain products to reduce the risk. Prior to conception, women are now urged to take 400 micrograms of daily folic acid supplementation.

The new data showed no additional decrease in spina bifida among infants born to non-Hispanic white and Hispanic mothers since mandatory folic acid fortification was implemented, but a 20 percent decrease was registered among infants born to non-Hispanic black mothers, according to the CDC review, which looked at statistics from 1999 to 2005. The findings were published in the Jan. 9 issue of the CDC's Morbidity and Mortality Weekly Report.

"Future public health efforts to reduce the prevalence of spina bifida should focus on subgroups of women with known risk factors for an NTD-affected pregnancy, such as obesity, Hispanic ethnicity, and certain genetic factors. Additional study of genetic and environmental risk and protective factors is warranted," the CDC review said. "Future decreases in the prevalence of spina bifida might be attenuated as the percentage of NTDs preventable by consuming folic acid continues to diminish," the report added.

An estimated 50 percent to 70 percent of neural tube disorders can be prevented through daily consumption of 400 micrograms of folic acid, the study said.

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Salmonella Cases Still a Mystery

Georgia, Ohio and Minnesota are among the 42 states now affected by the salmonella bacterium that has continued to sicken hundreds of Americans during the past three months with a reported 388 cases, the Associated Press said Thursday.

Georgia officials said they've identified five people who became ill from mid-October to mid-December. No one died, but at least one person was hospitalized. In Ohio, 51 people in 20 counties, where at least a dozen were hospitalized, had the same type of salmonella about the same time as the Georgia cases, health officials said.

A Minnesota health official said Thursday the state has had 30 cases, while in California, 51 cases had been reported as of last week, AP said.

USA Today also reported that officials from the U.S. Centers for Disease Control and Prevention (CDC) have become concerned enough about the latest incidences to form a task force to find the cause. The CDC is leading the investigation but has not yet released the full list of states or determined which foods may have caused the illnesses.

This can be a daunting task. For example, more than 1,400 people in the United States suffered from salmonella poisoning in 2008 before the source was found -- peppers imported from Mexico. And another 401 cases in 41 states were reported in November, caused by the bacterium in microwaveable pot pies.

Infectious disease specialists don't yet know the source of the current illnesses, if there is indeed a single source.

The CDC says salmonella symptoms include nausea, diarrhea, stomach cramps and fever, and it usually is spread by fecal matter coming in contact with food people eat, whether animal or vegetable.

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Large Lab Admits Problems With Vitamin D Tests

Quest Diagnostics, the largest provider of medical laboratory tests in the United States, says it has fixed a problem that led to higher vitamin D readings for about 7 percent of patients from 2007 to 2008, the Associated Press reported Wednesday.

The Madison, N.J., lab said it noticed an "upward trend" in the vitamin D levels being registered on some of its tests during the summer, then offered free tests for patients whose results were called into question, according to Gary Samuels, the company's vice president for communications. Blood tests to check vitamin D levels are on the rise, because research has shown a possible link between too little "sunshine vitamin" and a higher risk for cancer and heart disease.

Quest's chief medical official, Dr. Wael Salameh, told AP that he doubted patients would have suffered any harm. People with serious vitamin D deficiency, he said, often exhibit physical symptoms such as fractures that doctors would have noticed. "A good doctor would question the test," Salameh added. "For the few vulnerable patients, other indicators would have flagged the situation to their physician."

Quest said the cause of the problem proved to be how some of the company's testing chemicals were mixed. But the company is using a new testing technology, AP reported, which critics say tends to produce higher vitamin D readings.

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FDA Mulls OK for Blood Thinner From Genetically Engineered Goats

The U.S. Food and Drug Administration is moving closer to approval for an anti-clotting drug made from the milk of genetically engineered goats, the Associated Press reported Wednesday.

Called ATryn, the drug was developed by GTC Biotherapeutics, a Massachusetts biotech company, by altering goat genes to produce milk rich in antithrombin, a protein that acts as a natural blood thinner in humans. ATryn has already been approved in Europe, and FDA advisers are expected to meet Friday to make a recommendation on approval. The FDA will then make the final decision, the news service said.

"It's the first time we've held an advisory committee meeting on any product from a genetically engineered animal," FDA spokeswoman Siobhan DeLancey told AP. If the drug is approved, DeLancey added, the agency may require follow-up monitoring to insure patients' immune systems don't make antibodies to the medication.

About 1 in 5,000 people don't produce enough antithrombin, putting them at risk of developing painful blood clots that can break loose and travel through the bloodstream to the lungs or the brain, AP reported. Pregnant women with the disorder are at high risk of miscarriage or stillbirth because of blood clots in the placenta.

Antithrombin has until now been produced from blood products collected from human donors, one expert told AP, but making the protein from goats may be better for humans, since it could ensure a steady supply and reduce concerns about infection.

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