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MEASLES SURGES IN UK YEARS AFTER FLAWED RESEARCH
Tuesday, 21 May 2013 08:43 Published in Health & FitnessThis year, the U.K. has had more than 1,200 cases of measles, after a record number of nearly 2,000 cases last year. The country once recorded only several dozen cases every year. It now ranks second in Europe, behind only Romania.
Last month, emergency vaccination clinics were held every weekend in Wales, the epicenter of the outbreak. Immunization drives have also started elsewhere in the country, with officials aiming to reach 1 million children aged 10 to 16.
"This is the legacy of the Wakefield scare," said Dr. David Elliman, spokesman for the Royal College of Paediatrics and Child Health, referring to a paper published in 1998 by Andrew Wakefield and colleagues that is widely rejected by scientists.
That work suggested a link between autism and the combined childhood vaccine for measles, mumps and rubella, called the MMR. Several large scientific studies failed to find any connection, the theory was rejected by at least a dozen major U.K. medical groups and the paper was eventually retracted by the journal that published it.
Britain's top medical board stripped Wakefield of the right to practice medicine in the U.K., ruling that he and two of his colleagues showed a "callous disregard" for the children in the study, subjecting them to unnecessary, invasive tests. As part of his research, Wakefield took blood samples from children at his son's birthday party, paying them about 5 pounds each ($7.60), and later joked about the incident.
Still, MMR immunization rates plummeted across the U.K. as fearful parents abandoned the vaccine - from rates over 90 percent to 54 percent. Wakefield has won support from parents suspicious of vaccines, including Hollywood celebrities like Jenny McCarthy, who has an autistic son.
Nearly 15 years later, the rumors about MMR are still having an impact. Now there's "this group of older children who have never been immunized who are a large pool of infections," Elliman said.
The majority of those getting sick in the U.K. - including a significant number of older children and teens - had never been vaccinated. Almost 20 of the more than 100 seriously ill children have been hospitalized and 15 have suffered complications including pneumonia and meningitis. One adult with measles has died, though it's unclear if it was the disease that killed him.
The first measles vaccines were introduced in the 1960s, which dramatically cut cases of the rash-causing illness. Since 2001, measles deaths have dropped by about 70 percent worldwide; Cambodia recently marked more than a year without a single case.
Globally, though, measles is still one of the leading causes of death in children under 5 and kills more than 150,000 people every year, mostly in developing countries. Measles is highly contagious and is spread by coughing, sneezing and close personal contact with infected people; symptoms include a fever, cough, and a rash on the face.
Across the U.K., about 90 percent of children under 5 are vaccinated against measles and have received the necessary two doses of the vaccine. But among children now aged 10 to 16, the vaccination rate is slightly below 50 percent in some regions.
To stop measles outbreaks, more than 95 percent of children need to be fully immunized. In some parts of the U.K., the rate is still below 80 percent.
Unlike in the United States, where most states require children to be vaccinated against measles before starting school, no such regulations exist in Britain. Parents are advised to have their children immunized, but Britain's Department of Health said it had no plans to consider introducing mandatory vaccination.
Last year, there were 55 reported cases of measles in the United States, where the measles vaccination rate is above 90 percent. So far this year, there have been 22 cases, including three that were traced to Britain. In previous years, the U.K. has sometimes exported more cases of measles to the U.S. than some countries in Africa.
Portia Ncube, a health worker at an East London clinic, said the struggle to convince parents to get the MMR shot is being helped by the measles epidemic in Wales.
"They see what's happening in Wales, so some of them are now sensible enough to come in and get their children vaccinated," she said.
Clinic patient Ellen Christensen, mother of an infant son, acknowledged she had previously had some "irrational qualms" about the MMR vaccine.
"But after reading more about it, I know now that immunization is not only good for your own child, it's good for everyone," she said.
--- Online: Public Health England's Measles website: HTTP://WWW.HPA.ORG.UK/TOPICS/INFECTIOUSDISEASES/INFECTIONSAZ/MEASLES/ --- AP Medical Writer Mike Stobbe in New York contributed to this report. © 2013 THE ASSOCIATED PRESS. ALL RIGHTS RESERVED. THIS MATERIAL MAY NOT BE PUBLISHED, BROADCAST, REWRITTEN OR REDISTRIBUTED. Learn more about our PRIVACY POLICY and TERMS OF USE.
AFTER A DECADE, GLOBAL AIDS PROGRAM LOOKS AHEAD
Tuesday, 21 May 2013 08:40 Published in Health & FitnessThe President's Emergency Plan for AIDS Relief grew out of an unlikely partnership between President George W. Bush and lawmakers led by the Congressional Black Caucus. It has come to represent what Washington can do when it puts politics aside - and what America can do to make the world a better place.
President Barack Obama, speaking at the recent dedication of Bush's presidential library, praised the compassion Bush showed in "helping to save millions of lives and reminding people in some of the poorest corners of the globe that America cares."
House Democratic leader Nancy Pelosi said of Bush in a statement that "while many events may distinguish his presidency, his devotion to combatting the scourge of HIV/AIDS will certainly define his legacy."
The AIDS program's future, however, is uncertain. Obama has upped the stakes, speaking in his State of the Union address this year of "realizing the promise of an AIDS-free generation." But funding for the relief plan's bilateral efforts has dipped in recent years and it's doubtful that Congress, in its current budget-cutting mood, will reverse that trend when the current five-year program expires later this year.
The AIDS program is also trying to find a balance between its goals of reaching more people with its prevention and treatment programs and turning over more responsibility to the host nations where it operates.
"This has been an incredible achievement," said Rep. Barbara Lee, D-Calif., a senior Congressional Black Caucus member who played major roles both in passing the original 2003 act and its 2008 renewal that significantly increased funding for AIDS, malaria and tuberculosis treatment in Africa and other areas of the developing world. She spoke of the more than 5 million people now receiving life-saving antiretroviral treatment and 11 million pregnant women who received HIV testing and counseling last year. "But I'm worried that with any type of level-funding or cuts we'll go backward," she said.
The 2008 act more than tripled funding from the 2003 measure, approving $48 billion over five years for bilateral and global AIDS programs, malaria and tuberculosis. It also ended U.S. policy making it almost impossible for HIV-positive people to get visas to enter the country.
The AIDS program was the largest commitment ever by a nation to combat a single disease internationally. According to the U.N.'s UNAIDS and the Kaiser Family Foundation, in 2011 the United States provided nearly 60 percent of all international AIDS assistance.
A decade ago, almost no one in sub-Saharan Africa was receiving antiretroviral treatment. By 2008, the AIDS program had boosted that number to 1.7 million. As of last year it was 5.1 million.
The State Department says the program last year also helped provide treatment to some 750,000 HIV-positive pregnant women, allowing about 230,000 infants to be born HIV-free, supported 2 million male circumcisions and directly supported HIV testing and counseling for 46.5 million.
"This is a remarkable story that the American people should know about," Kimberly Scott of the Institute of Medicine, which recently completed an evaluation of the AIDS program, said at a forum sponsored by the Kaiser Family Foundation and the CSIS Global Health Policy Center.
According to UNAIDS, the number of people living with HIV has leveled off, standing at about 34 million at the end of 2011. New infections that year reached 2.5 million, down 20 percent from 2001. AIDS-related deaths were 1.7 million, down from 2.3 million in 2005.
Jennifer Kates, director of global health and HIV policy at Kaiser, said most countries where the program operates have yet to reach the "tipping point," where new infections occurring in a year are less than the increase in people receiving treatment. Among the success stories were Ethiopia, where the 40,000 going on treatment in 2011 was almost four times the new infections. Still with a long way to go was Nigeria, which that year had 270,000 new HIV infections and a 57,000 increase in those getting treatment.
Chris Collins, director of public policy at amfAR, The Foundation for AIDS Research, also warned of potential repercussions as the AIDS program shifts from being an emergency response to the AIDS epidemic to a more supportive role for country-based health programs.
"The countries themselves largely are avoiding the important role that key populations play in epidemics," he said, referring to gay men, those injecting drugs and sex workers. These groups face discrimination and criminal charges in many cases, and 90 percent of the money to help them now comes from external sources.
Collins also spoke of the "huge mismatch" between the positive science and rhetoric on fighting AIDS and the money available. Since 2009 the funding for bilateral and global HIV and AIDS programs has largely stalled.
Kaiser's Kates said that while there's still bipartisan support for the AIDS program in Congress, "the big question is will the financing be there to reach the goals" of treating more people and advancing toward that AIDS-free generation. "The challenge right now is that the global economic climate is different, the U.S. climate is different, but the need is still great."
© 2013 THE ASSOCIATED PRESS. ALL RIGHTS RESERVED. THIS MATERIAL MAY NOT BE PUBLISHED, BROADCAST, REWRITTEN OR REDISTRIBUTED. Learn more about our PRIVACY POLICY and TERMS OF USE.
The report released by the Interior Department's Office of Inspector General found that park officials responded to last summer's outbreak appropriately and within department policy.
"When the outbreak was identified, NPS mobilized to contain and remediate the outbreak and to prevent further outbreaks," Mary Kendall, a deputy inspector general, wrote in a letter attached to the report.
Still, the report found that current policy didn't require park officials to approve design changes made to the "Signature tent cabins" by concessionaire Delaware North Companies Parks and Resorts, which added rafters and wall studs to the structures.
Investigators determined that deer mice, which can carry the illness, nested inside the double walls of the new tents in Yosemite's family friendly Curry Village.
At least eight of the nine tourists who fell ill stayed in the tent cabins.
Because the changes to the cabins were considered routine maintenance, current park service policy did not require prior approval, the report found.
The report also recommended that the park service begin cyclical pest monitoring and inspections of all public accommodations.
While there is a current pest monitoring program at Yosemite, Delaware North was responsible for Curry Village, which was not considered at high risk for hantavirus.
The company issued a statement late Monday saying it would follow the recommendations in the report.
"DNC Parks & Resorts at Yosemite has consistently worked hand-in-hand with the National Park Service and public health officials on this issue," spokeswoman Lisa Cesaro said in the statement. "The Signature Tent Cabins have been removed from Curry Village. We are following the recommendations by the National Park Service, which were developed in consultation with the California Department of Public Health and the Centers for Disease Control and Prevention."
Prior to the outbreak, Delaware only responded to pests in the cabins when visitors or housekeeping staff complained, the report said.
© 2013 THE ASSOCIATED PRESS. ALL RIGHTS RESERVED. THIS MATERIAL MAY NOT BE PUBLISHED, BROADCAST, REWRITTEN OR REDISTRIBUTED. Learn more about our PRIVACY POLICY and TERMS OF USE.
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