Health & Fitness (206)
The Albert and Mary Lasker Foundation announced the recipients of the $250,000 prizes on Monday. The awards will be presented Sept. 20 in New York City.
The Gateses won the public service award "for leading a historic transformation in the way we view the globe's most pressing health concerns and improving the lives of millions of the world's most vulnerable," the Lasker foundation said.
They have donated more than $26 billion to their philanthropic foundation. They often team up with agencies that can provide diverse expertise, the Lasker foundation said, noting that they supported an international partnership that has helped immunize hundreds of millions of children against killer diseases. Their current priorities include polio, agriculture and family-planning information and services.
The Lasker clinical medical research award will be shared by Graeme Clark, an emeritus professor at the University of Melbourne in Australia, Ingeborg Hochmair of the company MED-EL in Innsbruck, Austria, and Blake Wilson of Duke University in North Carolina, for developing the modern cochlear (KAH'-klee-er) implant. More than 320,000 people around the world use the implants for severe hearing loss, the foundation said.
The devices stimulate the auditory nerve with electric signals. Hochmair and Clark worked independently, in the face of scientific skepticism that electrical stimulation could produce meaningful hearing. The implants were approved in the U.S. in 1985.
Wilson later designed a new way for implants to process speech, which has allowed most users to understand words and sentences with no visual cues. The advance fueled a growth in implant use that began in the early 1990s, the foundation said.
The Lasker award for basic medical research will be shared by Richard Scheller of the biotech company Genentech and Dr. Thomas Sudhof of Stanford University. With research they began independently in the late 1980s, they unraveled details of how brain cells release chemical messengers to communicate with each other. Scientists are beginning to find connections between the molecular equipment they studied and serious illnesses like Parkinson's disease, the foundation said.
A study released Thursday by the nonprofit Kaiser Family Foundation found that government tax credits would lower the sticker price on a benchmark "silver" policy to a little over $190 a month for single people making about $29,000, regardless of their age.
By pairing their tax credit with a stripped-down "bronze" policy, some younger consumers can bring their premiums down to the range of $100 to $140 a month, while older people can drive their monthly cost even lower - well below $100 - if they are willing to take a chance with higher deductibles and copays.
A separate study released Wednesday from Avalere Health, a private data analysis firm, took a wide-angle view, averaging the sticker prices of policies at different coverage levels.
Before tax credits that act like a discount, premiums for a 21-year-old buying a mid-range "silver" policy would be about $270 a month, the Avalere study found. List-price premiums for a 40-year-old buying a mid-range plan will average close to $330. For a 60-year-old, they were nearly double that at $615 a month.
Starting Oct. 1, those who don't have health care coverage on the job can go to new online insurance markets in their states to shop for a private plan and find out if they qualify for a tax credit. An estimated 4 out 5 consumers in the new markets will be eligible for some level of tax credit.
Come Jan. 1, virtually all Americans will be required to have coverage, or face fines. At the same time, insurance companies will no longer be able to turn away people in poor health.
The Obama administration, which is running the markets or taking the lead in 35 states, is not expected to release final premiums until close to the Oct. 1 launch date. But the two private studies provide an early look at the emerging market.
Caroline Pearson, lead author of the Avalere study, said it will be competitive, but there will be big price differences among age groups, states and even within states.
The bottom line is mixed: Many consumers will like their new options, particularly if they qualify for a tax credit. But others may have to stretch to afford coverage.
"We are seeing competitive offerings in every market if you buy toward the low end of what's available," said Pearson, a vice president of Avalere.
However, for uninsured people who are paying nothing today, "this is still a big cost that they're expected to fit into their budgets," Pearson added.
The Obama administration said consumers will have options that are cheaper than the averages presented in the Avalere study. "We're consistently seeing that premiums will be lower than expected," she said. "For the many people that qualify for a tax credit, the cost will be even lower."
The Kaiser study found that while premiums will vary significantly across the country, they are generally coming in lower than forecast by the government's own experts. It cautioned against comparing premiums under Obama's law to what individually insured people currently pay, because the new coverage is more robust.
Avalere crunched the numbers on premiums filed by insurers in 11 states and Washington, D.C. Kaiser analyzed 17 states and the District of Columbia. Both studies included a mix of states running their own insurance markets and ones in which the federal government will take charge.
The states analyzed by Avalere were California, Connecticut, Indiana, Maryland, New York, Ohio, Rhode Island, South Dakota, Vermont, Virginia and Washington.
In addition to those, Kaiser included Colorado, Maine, Montana, Nebraska, New Mexico and Oregon.
No data on premiums were publicly available for Texas and Florida - together they are home to more than 10 million of the nation's nearly 50 million uninsured people - and key to the law's success.
However, Pearson said she's confident the premiums in the Avalere study will be "quite representative" of other states, because clear pricing patterns emerged.
Four levels of plans will be available under Obama's law: bronze, silver, gold and platinum. Bronze plans will cover 60 percent of expected medical costs; silver plans will cover 70 percent; gold will cover 80 percent and platinum 90 percent.
All plans cover the same benefits, but bronze features the lowest premiums, paired with higher deductibles and copays. Platinum plans would have the lowest out-of-pocket costs and the highest premiums.
Mid-range silver plans are considered the benchmark, because the tax credits will be keyed to the cost of the second-lowest-cost silver plan in a local area.
And there's another important detail for consumers to be aware of: People with modest incomes may come out ahead by sticking with a silver plan instead of going for the lower premiums with bronze. Additional help with out-of-pocket costs like copays will only be available to people enrolling in a silver plan.
Although the sticker price for premiums rises dramatically above age 40, the tax credits are shaping up as a powerful equalizer for older consumers. That's because they work by limiting what you pay for premiums to a given percentage of your income.
For example, someone making $23,000 would pay no more than 6.3 percent of his or her annual income - $1,450 - for a benchmark silver plan. The amount you pay stays the same whether the total premium is $3,000 or $9,000.
However, those tax credits taper off rapidly for people with solid middle-class incomes, above $30,000 for an individual and $60,000 for a family of four.
The Avalere study also found some striking price differences within certain states, generally larger ones. In New York, with 16 insurers participating, the difference between the cheapest and priciest silver premium was $418.
WASHINGTON (AP) — Flu vaccination is no longer merely a choice between a jab in the arm or a squirt in the nose. This fall, some brands promise a little extra protection.
For the first time, certain vaccines will guard against four strains of flu rather than the usual three. Called quadrivalent vaccines, these brands may prove more popular for children than their parents. That's because kids tend to catch the newly added strain more often.
These four-in-one vaccines are so new that they'll make up only a fraction of the nation's supply of flu vaccine, so if you want a dose, better start looking early.
But that's only one of an unprecedented number of flu vaccine options available this year.
Allergic to eggs? Egg-free shots are hitting the market, too.
Plus there's growing interest in shots brewed just for the 65-and-older crowd, and a brand that targets the needle-phobic with just a skin-deep prick.
"We're moving away from the one-size-fits-all to choosing the best possible vaccine for an individual's age and condition," said Dr. Gregory Poland, an infectious disease specialist at the Mayo Clinic.
"The flip side of that," he said, is that "this will be a confusing year" as doctors and consumers alike try to choose.
Federal health officials recommend a yearly flu vaccine for nearly everyone, starting at 6 months of age. On average, about 24,000 Americans die each flu season, according to the Centers for Disease Control and Prevention.
Some questions and answers about the different vaccine varieties to choose from:
Q: What's the difference between those new four-strain vaccines and the regular kind?
A: For more than 30 years, the vaccine has offered protection against three influenza strains — two common Type A strains called H1N1 and H3N2, and one strain of Type B. Flu strains continually evolve, and the recipe for each year's vaccine includes the subtypes of those strains that experts consider most likely to cause illness that winter.
Type A flu causes more serious disease and deaths, especially the H3N2 form that made last year such a nasty flu season. But the milder Type B flu does sicken people every year as well, and can kill. Two distinct Type B families circulate the globe, making it difficult to know which to include in each year's vaccine. Adding both solves the guesswork, and a CDC model estimates it could prevent as many as 485 deaths a year depending on how much Type B flu is spreading.
Q: How can I tell if I'm getting the four-strain vaccine?
A: All of the nasal spray version sold in the U.S. this year will be this new variety, called FluMist Quadrivalent. The catch is that the nasal vaccine is only for healthy people ages 2 to 49 who aren't pregnant.
If you prefer a flu shot, ask the doctor or pharmacist if the four-strain kind is available. Younger children, older adults, pregnant women and people with chronic health conditions all can use flu shots. Four-strain versions are sold under the names Fluzone Quadrivalent, Fluarix Quadrivalent and FluLaval Quadrivalent.
Manufacturers anticipate producing between 135 million and 139 million doses of flu vaccine this year. Only about 30 million doses will offer the four-strain protection.
Q: Who should seek it?
A: Type B flu tends to strike children more than the middle-aged, Poland noted. And he said it's not a bad idea for seniors, who are more vulnerable to influenza in general. But the CDC doesn't recommend one vaccine variety over another, and the American Academy of Pediatrics said either kind is fine — just get vaccinated.
Q: How are these new vaccines different from the high-dose flu shot for seniors?
A: Fluzone High-Dose protects against the traditional three strains of flu, but it quadruples the standard vaccine dose in an effort to rev up age-weakened immune systems don't respond as actively to regular flu shots.
The government calls the high-dose shot an option for seniors, not one that's proved better. Last week, Sanofi Pasteur said initial results from a study of 30,000 seniors vaccinated over the past two flu seasons suggest the high-dose shot is about 24 percent more effective. Federal health officials will have to review the full study results to see if they agree.
Q: What if I'm allergic to eggs?
A: Traditional flu vaccine is made from viruses grown in eggs, and specialists say it's usually not a problem unless someone has a serious egg allergy. But the new FluBlok vaccine eliminates that concern because it is made with cell technology, like many other nonflu vaccines. So far, it's only for use in people ages 18 to 49.
Q: What if I'm scared of needles?
A: If you don't qualify for the ouchless nasal spray vaccine, there is one shot made with a teeny-tiny needle that pricks the skin instead of muscle. Called Fluzone Intradermal, it's available for 18- to 64-year-olds, and protects against the usual three strains.
Q: How soon should I be vaccinated?
A: Early fall is ideal, as it's impossible to predict when flu will start spreading and it takes about two weeks for protection to kick in. But later isn't too late; flu season typically peaks in January or February.
Q: How much does flu vaccine cost?
A: The vaccine is covered by insurance, and Medicare and some plans don't require a copay. Drugstore vaccination programs tend to charge about $30; expect the quadrivalent versions to be slightly more expensive.
Johnson & Johnson says the warning will appear on the cap of new bottles of Extra Strength Tylenol sold in the U.S. starting in October and on most other Tylenol bottles in coming months. The warning will make it explicitly clear that the over-the-counter drug contains acetaminophen, a pain-relieving ingredient that is the nation's leading cause of sudden liver failure.
"We're always looking for ways to better communicate information to patients and consumers," says Dr. Edwin Kuffner, vice president of McNeil Consumer Healthcare, the Johnson & Johnson unit that makes Tylenol.
Overdoses from acetaminophen send 55,000 to 80,000 people in the U.S. to the emergency room each year and kill at least 500, according to the Centers for Disease Control and Prevention and the Food and Drug Administration. Acetaminophen can be found in more than 600 over-the-counter and prescription products used by nearly one in four American adults every week, including household brands like Nyquil cold formula, Excedrin pain tablets and Sudafed sinus pills.
Tylenol is the first of these products to include such a warning label on the bottle cap. McNeil says the warning is a result of research into the misuse of Tylenol by consumers. The new cap message will read: "CONTAINS ACETAMINOPHEN" and "ALWAYS READ THE LABEL."
The move comes at a critical time for the company, which faces more than 85 personal injury lawsuits in federal court that blame Tylenol for liver injuries and deaths. At the same time, the Food and Drug Administration is drafting long-awaited safety proposals that could curtail the use of Tylenol and other acetaminophen products.
Much is at stake for McNeil and its parent company. Johnson & Johnson does not report sales of Tylenol, but total sales of all over-the-counter medicines containing acetaminophen were more than $1.75 billion last year, according to Information Resources Inc., a retail data service.
Safety experts are most concerned about "extra-strength" versions of Tylenol and other pain relievers with acetaminophen found in drugstores. A typical two-pill dose of Extra Strength Tylenol contains 1,000 milligrams of acetaminophen, compared with 650 milligrams for regular strength. Extra Strength Tylenol is so popular that some pharmacies don't even stock regular strength.
Most experts agree that acetaminophen is safe when used as directed, which generally means taking 4,000 milligrams, or eight pills of Extra Strength Tylenol or less, a day.
Each year, some 100 million Americans use acetaminophen, but liver damage occurs in only a fraction of 1 percent of users. Still, liver specialists say those cases are preventable. Part of the problem, they say, is that there are sometimes hundreds of pills in a bottle, making it easy for consumers to pop as many as they please. For example, McNeil sells Extra Strength Tylenol in bottles containing up to 325 tablets
"The argument goes that if you take acetaminophen correctly you will virtually never get into trouble," says Dr. William Lee of the UT Southwestern Medical Center, who has studied acetaminophen toxicity for four decades. "But it's the very fact that it's easily accessible over-the-counter in bottles of 300 pills or more that puts people in harm's way."
Lee applauded the new warning, but said McNeil's marketing has contributed to the "freewheeling" way that Americans take the drug. For decades, McNeil has advertised Tylenol as "the safest kind of pain reliever" when used as directed. "That has been their standard ploy in the past, and I would argue that safest it is not," he says.
McNeil's Kuffner stands by the company's safety claim: "When taken as directed, when people read and follow the label, I believe that Tylenol and the acetaminophen ingredient is one of the safest pain relievers on the market."
McNeil is the only major drugmaker adopting the bottle cap warning at this time, according to the Consumer Healthcare Products Association, a trade group for over-the-counter medicine companies.
"While this is not an industrywide initiative at this time, it fits squarely within the many ongoing industrywide educational initiatives to further acetaminophen safe and responsible use by consumers," said Emily Skor, a vice president with the trade group, which represents McNeil, Bayer Healthcare, Procter & Gamble and other nonprescription drugmakers.
20 YEARS OF WARNINGS
McNeil has updated the safety warnings on Tylenol periodically since the 1990s.
In 1994, the company added a warning about the risk of liver damage when combining alcohol with Tylenol following a lawsuit brought by Antonio Benedi, a former aide to President George H.W. Bush, who fell into a coma and underwent emergency liver transplant after mixing Tylenol with wine at dinner.
A jury awarded him $8.8 million in damages after concluding that McNeil failed to warn consumers about the risk. The FDA made the alcohol warning mandatory for all manufacturers of acetaminophen in 1998.
Then, in 2002, an expert panel of FDA advisers recommended that the government agency require all acetaminophen products to carry a warning about the risk of "severe liver damage" when not taken as directed. The group's votes are non-binding, though the FDA usually follows them. McNeil voluntarily added the warning to its products in 2004, five years before the FDA made it mandatory.
Today, McNeil appears to be moving ahead of regulators again. In 2009, the FDA assembled another expert panel to consider more sweeping changes to reduce acetaminophen overdoses. The panel recommended a half-dozen major changes, including lowering the maximum nonprescription daily dose for adults. McNeil voluntarily adopted that recommendation, lowering the recommended adult dose of Extra Strength Tylenol to 3,000 milligrams per day, or six pills of Extra Strength Tylenol, down from 4,000 milligrams per day, or eight pills. The label stipulates that patients can still take a higher dose under doctor's directions.
But the company has not embraced a more drastic recommendation by the FDA's expert panel: eliminating the over-the-counter "extra-strength" formulation altogether, which would mean lowering the acetaminophen dose from 1,000 milligrams to 650 milligrams, or two tablets of 325 milligrams each. The panel said the 1,000 milligram dose should only be available via prescription.
McNeil argues that the lower dose is less effective and could drive people to take anti-inflammatory pain relievers, a different class of drugs that includes aspirin and ibuprofen. Those medicines can cause stomach ulcers and dangerous gastrointestinal bleeding.
FDA spokeswoman Erica Jefferson says the agency is actively working on new rules for both children and adult acetaminophen products. While the agency won't give a timeframe for completion, the federal government's website that tracks new regulations lists December as the target date for publishing the proposed rules.
As early as 1977, FDA advisers recommended adding more warnings to the acetaminophen label about liver damage, but the agency didn't require the language until 2009.
"They are very slow to respond to these things and it's always a little frustrating," says Dr. Lewis Nelson of New York University, who chaired the 2009 FDA panel.
ANATOMY OF AN OVERDOSE
Experts first identified acetaminophen overdose as a major public health concern in the 1990s, but it has taken years to form a clearer picture of the problem.
Acetaminophen overdoses occur when the liver is overwhelmed by too much of the drug, producing a toxic byproduct that kills liver cells. Liver failure occurs when most cells are no longer able to function. At that point, a patient then generally has 24 to 48 hours to live without a transplant.
Of the roughly 500 acetaminophen deaths reported annually, about half are accidental, with the rest deemed suicides. About 60 percent of the unintentional overdoses involve prescription opioid-acetaminophen combination drugs such as Percocet and Vicodin, according to a database of liver failure cases run by Dr. Lee at the Southwestern Medical Center in Dallas. Those two products alone were prescribed more than 173 million times last year, according to IMS Health.
So how do these accidental acetaminophen deaths occur? Imagine you've had major dental surgery, and your dentist prescribes a five-day supply of Percocet. You take the recommended two pills every six hours for 2,600 milligrams of acetaminophen, well below the 4,000-milligram-a-day safety threshold.
But you're still experiencing pain, so you decide to add Extra Strength Tylenol, six caplets a day for another 3,000 milligrams. Now you're feeling better but you still have trouble sleeping, so you take Nyquil, for another 650 milligrams. After a few days on this 6,250 milligram regimen, experts say acute liver damage is a real risk.
The labels on all of these products warn against mixing them. But researchers say many consumers either don't read or don't understand such warnings.
Even after taking into account people who ignore labels, there are still cases of liver damage that stump researchers. These are the people who have apparently taken about 4,000 milligrams a day or less, well within the safety threshold.
"It's still a little bit of a puzzle," says Dr. Anne Larson, of the Swedish Medical Center in Seattle. "Is it genetic predisposition? Are they claiming they took the right amount, but they really took more? It's difficult to know."
The question is critical in the lawsuits piling up against McNeil in the Eastern District of Pennsylvania, near McNeil's headquarters in Fort Washington, Pa. Virtually all of the 85 cases claim that the plaintiffs suffered liver failure despite taking Tylenol as directed.
According to one of those complaints, Madeline Speal, of Salzburg, Pa., took Tylenol for three days in November 2009 "at appropriate times and in appropriate doses." But on Nov. 28, she was admitted to Latrobe Area Hospital with catastrophic liver damage. She was then transferred to the University of Pittsburgh Medical Center where she underwent an emergency liver transplant.
The cases against McNeil, which share the same legal wording, allege that the company risked the lives of consumers by making "conscious decisions not to redesign, re-label, warn or inform the unsuspecting consuming public."
The lawsuits have been consolidated under a single federal judge to streamline the pretrial process, though they will eventually be returned to judges in their original districts for trial.
J&J and McNeil continue to reiterate that Tylenol is safe. "We remain confident in the safety and efficacy of Tylenol products, which rightfully have been trusted by doctors, hospitals and consumers for more than 50 years," McNeil said in a statement.
But lawyers for the patients suing McNeil say Tylenol can still be dangerous even when used at or just above recommended levels.
"Products that are available to consumers should have a reasonable margin of safety," said Laurence Berman, one of several attorneys representing Tylenol users.
About 1 in 5 boys got at least one of the recommended three doses last year, relatively good for a new vaccine aimed at adolescents.
The shots are largely intended not to protect boys from disease, but to stop them from spreading a sexually transmitted virus to girls that could cause cervical cancer.
The vaccine hasn't been very popular among girls. The government report issued Thursday is the first real sense of how many boys are getting the shots.
"It's a good start," said Shannon Stokley, a vaccination expert with the Centers for Disease Control and Prevention.
Introduced in 2006, the vaccine protects against human papillomavirus, which is spread during sex. Most infections go away on their own, without people developing symptoms. But the virus can cause cervical cancer in females, genital warts in both sexes, and some other, less common conditions like throat and anal cancer.
The vaccine was first recommended for girls ages 11 and 12 because it works best if given before a teen starts to have sex. In 2011, it was also recommended for boys that age to help prevent the virus's spread.
The CDC report covers vaccination rates for last year, the first full year since the shots were advised for boys. It's based on telephone calls to families for about 19,000 boys and girls ages 13 to 17.
About 21 percent of the boys had gotten at least one of the three doses. Less than 7 percent were fully vaccinated.
The rates look relatively good compared to the initial rates for some other vaccines aimed at adolescents. For example, the initial rate for a meningococcal vaccine was just 12 percent.
Rates tend to start low when a vaccine is first recommended and build after. So the HPV numbers for boys are reason to be optimistic, said the CDC's Dr. Melinda Wharton, although she added a word of caution.
"Given how the coverage level has stalled for girls, though, a solid start isn't enough," she said.
For girls, the initial rate for at least one HPV shot was 25 percent. Last year, it was about 54 percent and hadn't changed much from the previous two years. Only a third was fully immunized with all three doses last year.
"We'd really like to do much better with boys and girls," Wharton said.
Federal officials say they don't have exact numbers but have seen isolated reports of schools cutting ties with the $11 billion National School Lunch Program, which reimburses schools for meals served and gives them access to lower-priced food.
Districts that rejected the program say the reimbursement was not enough to offset losses from students who began avoiding the lunch line and bringing food from home or, in some cases, going hungry.
"Some of the stuff we had to offer, they wouldn't eat," said Catlin, Ill., Superintendent Gary Lewis, whose district saw a 10 to 12 percent drop in lunch sales, translating to $30,000 lost under the program last year.
"So you sit there and watch the kids, and you know they're hungry at the end of the day, and that led to some behavior and some lack of attentiveness."
In upstate New York, a few districts have quit the program, including the Schenectady-area Burnt Hills Ballston Lake system, whose five lunchrooms ended the year $100,000 in the red.
Near Albany, Voorheesville Superintendent Teresa Thayer Snyder said her district lost $30,000 in the first three months. The program didn't even make it through the school year after students repeatedly complained about the small portions and apples and pears went from the tray to the trash untouched.
Districts that leave the program are free to develop their own guidelines. Voorheesville's chef began serving such dishes as salad topped with flank steak and crumbled cheese, pasta with chicken and mushrooms, and a panini with chicken, red peppers and cheese.
In Catlin, soups and fish sticks will return to the menu this year, and the hamburger lunch will come with yogurt and a banana - not one or the other, like last year.
Nationally, about 31 million students participated in the guidelines that took effect last fall under the 2010 Healthy, Hunger-Free Kids Act.
Dr. Janey Thornton, deputy undersecretary for USDA's Food, Nutrition and Consumer Services, which oversees the program, said she is aware of reports of districts quitting but is still optimistic about the program's long-term prospects.
"The vast majority of schools across the country are meeting the updated meal standards successfully, which is so important to help all our nation's children lead healthier lives," Thornton said.
"Many of these children have never seen or tasted some of the fruits and vegetables that are being served before, and it takes a while to adapt and learn," she said.
The agency had not determined how many districts have dropped out, Thornton said, cautioning that "the numbers that have threatened to drop and the ones that actually have dropped are quite different."
The School Nutrition Association found that 1 percent of 521 district nutrition directors surveyed over the summer planned to drop out of the program in the 2013-14 school year and about 3 percent were considering the move.
Not every district can afford to quit. The National School Lunch Program provides cash reimbursements for each meal served: about $2.50 to $3 for free and reduced-priced meals and about 30 cents for full-price meals. That takes the option of quitting off the table for schools with large numbers of poor youngsters.
The new guidelines set limits on calories and salt, phase in more whole grains and require that fruit and vegetables be served daily. A typical elementary school meal under the program consisted of whole-wheat cheese pizza, baked sweet potato fries, grape tomatoes with low-fat ranch dip, applesauce and 1 percent milk.
In December, the Agriculture Department, responding to complaints that kids weren't getting enough to eat, relaxed the 2-ounce-per-day limit on grains and meats while keeping the calorie limits.
At Wallace County High in Sharon Springs, Kan., football player Callahan Grund said the revision helped, but he and his friends still weren't thrilled by the calorie limits (750-850 for high school) when they had hours of calorie-burning practice after school. The idea of dropping the program has come up at board meetings, but the district is sticking with it for now.
"A lot of kids were resorting to going over to the convenience store across the block from school and kids were buying junk food," the 17-year-old said. "It was kind of ironic that we're downsizing the amount of food to cut down on obesity but kids are going and getting junk food to fill that hunger."
To make the point, Grund and his schoolmates starred last year in a music video parody of the pop hit "We Are Young." Instead, they sang, "We Are Hungry."
It was funny, but Grund's mother, Chrysanne Grund, said her anxiety was not.
"I was quite literally panicked about how we would get enough food in these kids during the day," she said, "so we resorted to packing lunches most days."
The FDA said Tuesday that Taylor Farms de Mexico could resume operations after investigators found conditions there "in accordance with known food safety protocols." The firm shut down voluntarily after its salad mix served at Olive Garden and Red Lobster restaurants was linked to 242 cyclospora infections in Nebraska and Iowa. Similar illnesses in 20 other states were never definitively linked to the farm.
The federal Centers for Disease Control and Prevention said it is working with Texas to try and discover the source of more than 250 cyclospora infections there.