TIME Infectious Disease

There’s a Vaccine Against Cancer, But People Aren’t Using It

The only vaccine to protect against cancer, the HPV shot, isn't being used by young people who could benefit most

In a new report on immunization rates among young people, the Centers for Disease Control (CDC) reports relatively low numbers of adolescents getting the HPV vaccine, the only vaccine that can protect against cancers — in the cervix, anus and mouth — caused by the human papillomavirus virus.

The new data, published in the CDC’s Morbidity and Mortality Weekly Report, shows that only about one-third of adolescent girls between the ages 13 and 17 got all three doses of the HPV vaccine, which the CDC says is about the same as last year. The shot is recommended to protect adolescents before they become sexually active. Only about 57% of adolescent girls and 35% of adolescent boys for whom the shot is recommended received one or more doses.

The vaccine continues to face challenges from parents concerned that it would promote sexual activity among pre-teens and adolescents, despite data showing that immunized teens aren’t more promiscuous. The CDC data also shows that doctors can play a critical role in discussing the shot with parents and improving vaccination rates. Among parents whose daughters were vaccinated against HPV, 74% said their doctors recommended the vaccine. But the data also showed that among parents who did not vaccinate their girls, nearly half were never told by their doctor that they should consider it. The effect was even greater among boys, where only 26% of parents who did vaccinate their son received any advice from their doctor about it.

To boost vaccination rates, some researchers are investigating whether fewer doses of the vaccine could be effective, and so far those studies look promising.

TIME Infectious Disease

CDC Lab Director In Anthrax Incident Resigns

MED CDC Anthrax
A sign marks the entrance to the federal Centers for Disease Control and Prevention in Atlanta on Oct. 8, 2013. David Goldman—AP

The lab director is now permanently out of the job

The director of the bioterror lab involved in an incident which caused over 80 lab workers to be potentially exposed to anthrax has resigned.

Michael Farrell, head of the Centers for Disease Control’s Bioterror Rapid Response and Advanced Technology Laboratory had submitted his resignation on Tuesday. The resignation was first reported by Reuters and has been confirmed by TIME.

Last month, the CDC reported that procedures to deactivate anthrax when leaving a lab were not followed and that while the workers were protected, the bacteria was passed to other labs. When it was determined that anthrax had not been deactivated, the labs and CDC building were shut down and decontaminated. Lab workers have not contracted the disease.

Last month, Dr. Farrell was reassigned as the CDC conducted its investigation. Earlier this month, CDC Director Dr. Thomas Frieden said the incident was due to a lack of oversight, and that the CDC would increase safety precautions.

 

TIME Infectious Disease

Sierra Leone’s Chief Ebola Doctor Contracts the Deadly Virus

Sheik Umar Khan, head doctor fighting the deadly tropical virus Ebola in Sierra Leone, poses for a picture in Freetown, June 25, 2014.
Sheik Umar Khan, head doctor fighting the deadly tropical virus Ebola in Sierra Leone, poses for a picture in Freetown, June 25, 2014. Reuters Staff—REUTERS

Symptoms of Ebola include high fevers, diarrhea and vomiting

The top doctor fighting Sierra Leone’s deadly ebola outbreak has contracted the virus himself, the country’s government said Tuesday.

Sheik Umar Khan, 39, is leading an assault on the virus that the World Health Organization says has already claimed 632 lives—206 in Sierra Leone alone as of July 17.

The ebola virus is ruthless, with a mortality rate of 90%. Transmitted through direct contact with the body fluid, blood and infected tissue of victims, ebola can easily spread to the health workers working hard to fight it.

“Health workers are prone to the disease because we are the first port of call for somebody who is sickened by disease. Even with the full protective clothing you put on, you are at risk,” Khan said in an interview with Reuters, before displaying the illness.

Khan is credited with treating more than 100 Ebola victims, Reuters reports, and is considered a “national hero” by the nation’s health ministry. The doctor has been moved to a treatment facility run by the medical charity Doctors Without Borders, according to a statement released Tuesday from the president’s office.

The outbreak began in Guinea this February, but has quickly spread across West Africa.

[Reuters]

TIME Infectious Disease

MERS Could Be Airborne, Research Indicates

The disease has already claimed 288 lives

Findings from a scientific paper published Tuesday indicated that Middle East Respiratory Syndrome (MERS) may be able to spread through the air.

A research team in Saudi Arabia collected air samples from a camel barn that the virus had previously plagued. Their analysis of the air sample tested positive for a strain of MERS RNA, CNN reports.

The possibility of MERS as an airborne illness has been previously floated after reports said that some of those infected previously had close contact to fellow MERS patients. The disease has claimed at least 288 live, according to the World Health Organization.

However, scientists are hesitant to jump to conclusions from these findings. “What they say is that virus particles can be airborne, but it’s premature to conclude that MERS is transmitted through aerosols,” said Dr. Mark Denison, a Vanderbilt University School of Medicine professor.

“Do we still need to consider the possibility of airborne transmission?” Denison added. “Yes, of course.”

[CNN]

TIME Infectious Disease

HIV Diagnosis Rate Fell by a Third in U.S. Over a Decade

HIV DIAGNOSES
This graphic shows the annual number of HIV diagnoses in the U.S., which has dropped by one-third in the past decade F.duckett—AP

A government study finds that HIV infection rates in the U.S. fell by one-third in the past decade, but young gay and bisexual men remain at high risk for the infection

(NEW YORK) — The rate of HIV infections diagnosed in the United States each year fell by one-third over the past decade, a government study finds. Experts celebrated it as hopeful news that the AIDS epidemic may be slowing in the U.S.

“It’s encouraging,” said Patrick Sullivan, an Emory University AIDS researcher who was not involved in the study.

The reasons for the drop aren’t clear. It might mean fewer new infections are occurring. Or that most infected people already have been diagnosed so more testing won’t necessarily find many more cases.

“It could be we are approaching something of a ‘ceiling effect,’” said one study leader, David Holtgrave of Johns Hopkins University.

The study was released online Saturday by the Journal of the American Medical Association. It is part of the journal’s special report on HIV research, issued ahead of the International AIDS Conference that starts Sunday in Melbourne, Australia.

HIV is the virus that causes AIDS, which destroys the immune system. The World Health Organization estimates 35 million people globally have the virus. In the United States, 1.1 million people are thought to be infected, though many don’t know it.

The study is based on HIV diagnoses from all 50 states’ health departments, which get test results from doctors’ office, clinics, hospitals and laboratories. The data span a decade, making this a larger and longer look at these trends than any previous study, said another study author, Amy Lansky of the federal Centers for Disease Control and Prevention.

The findings: 16 out of every 100,000 people ages 13 and older were newly diagnosed with HIV in 2011, a steady decline from 24 out of 100,000 people in 2002.

Declines were seen in the rates for men, women, whites, blacks, Hispanics, heterosexuals, injection drug users and most age groups. The only group in which diagnoses increased was young gay and bisexual men, the study found.

The diagnosis rate is a direct measure of when people actually tested positive for the virus. The diagnoses may be identifying infections that happened recently or years before.

The study found diagnosis rates dropped even as the amount of testing rose. In 2006, the CDC recommended routine HIV testing for all Americans ages 13 to 64, saying an HIV test should be as common as a cholesterol check. The percentage of adults ever tested for HIV increased from 37 percent in 2000 to 45 percent in 2010, according to CDC data.

Lansky acknowledged that given the testing increases, the new findings may seem like a bit of a paradox. One might assume that “if more people get tested, you’re more likely to find more people who are infected,” she said.

But several factors could explain the decline.

One is Holgrave’s ‘ceiling effect’ theory. Another is a possible ebb in new infections.

The CDC has been estimating about 50,000 new infections occur each year and that number has been holding steady in the past decade. That estimate comes from reports from 25 city and state health departments, joined with statistical modeling.

Lansky said maybe new infections are waning. Or maybe not, she and other experts said.

How could new infections be holding steady when diagnoses are falling? Perhaps the infection count might be buoyed by the expanding epidemic in young gay and bisexual men, said Sullivan, the Emory researcher.

TIME

Chikungunya in Florida Man Is First Case Acquired in the U.S.

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WS photography—Getty Images/Flickr RF

The Centers for Disease Control and Prevention (CDC) says that the first case of the mosquito-borne virus chikungunya infection picked up in the U.S. occurred in a Florida man who had not recently traveled abroad.

This year, 243 people in the U.S. became infected, but this is the first case of a disease believed to originate from a mosquito in the U.S.

Chikungunya is a disease caused by a virus that leads to fever, joint pain, headaches, swelling and rash. The infection is usually not fatal, but the pain can be debilitating.

“The arrival of chikungunya virus, first in the tropical Americas and now in the United States, underscores the risks posed by this and other exotic pathogens,” Roger Nasci, chief of CDC’s Arboviral Diseases Branch said in a statement.

The CDC is teaming up with the Florida Department of Health to confirm how the Florida man became infected and is monitoring the area for additional cases. The CDC believes that chikungunya in the U.S. will follow a similar pattern to that of the dengue virus, in which imported cases cause some local transmission, but did not cause a widespread outbreak. Public health officials are investigating how the mosquitoes were infected with the virus, including whether the insects acquired the virus by biting infected individuals. Since 2006, there have been an average of 28 cases a year of chikungunya infection; none of those cases have prompted an outbreak, however. Countries in Africa, Asia, Europe, India, the Middle East, and the French side of the Caribbean island of St. Martin have experienced outbreaks in the past and 23 countries have experienced local transmission of the virus in recent years.

The best way to stay protected from the virus is to keep mosquitoes at bay by wearing repellants and creating a physical barrier from being bitten, with long sleeves and pants when possible. Health officials also recommend getting rid of any standing water outside the home, where mosquitoes generally breed.

TIME Infectious Disease

Spacing Out Kids’ Vaccines Can Hurt Their Health, Experts Say

Girl getting immunization
Getty Images

All those shriek-inducing pokes may seem excessive but the rewards of following national vaccination guidelines far outweigh the risks, experts say

“Like any parent, I don’t like to see my child get a shot,” says Dr. Michael J. Smith, a pediatrician at the University of Louisville who has studied immunizations and developmental health outcomes among kids. “But these vaccine schedules are in place for a reason.” Smith compares skipping or postponing one of your child’s vaccinations to not buckling him or her in during a car ride. “You never know when you’re going to get hit. And if you delay or space out your child’s shots, not only are you putting your kids at risk, but you’re putting other people’s kids at risk too.”

The urgency of Smith’s warnings are borne out in the recent outbreaks of measles and pertussis, diseases that had been almost totally eradicated in the U.S. but have made a frightening comeback since the turn of the century—right around the time two now-discredited scientific papers suggested a possible link between vaccines and autism. Dozens of subsequent studies have demonstrated there are no links between vaccinations and autism. But while stats show most parents understand the importance of immunizing their kids, research from the University of Michigan indicates plenty of moms and dads—roughly 1 in 4—worry that current immunization guidelines may overburden their babies’ tiny immune systems.

The Centers for Disease Control and Prevention (CDC) currently recommend that all healthy babies be vaccinated against 12 different diseases or viruses during the first two years of life. That’s compared to eight back in the early 1990s. Recently added to the list are vaccinations against potentially deadly illnesses like hepatitis and chicken pox.

But while the number of vaccines (and needle pricks) has grown during the last two decades, the amount of antigen in those shots, which is the substance that triggers a response from your child’s immune system, has plummeted, Smith explains. “The actual burden on your child’s immune system is far lower that it was 10 or 20 years ago, even though kids now receive more shots,” he says. That’s credited to advances in protein science and a better understanding of the way diseases and children’s immune systems interact.

In an effort to provide some answers for concerned parents, Smith and his colleagues looked at kids’ scores on tests related to motor skill, verbal memory, attention span, and several other neuropsychological factor to see if vaccine timing had any impact—good or bad—on a child’s brain development. His research shows kids vaccinated on time score the same or better than children who receive their vaccinations late or not at all.

Related research from Canada looked specifically at the immunization decisions made by parents of children diagnosed with autism. “Our study found that roughly 60 percent of parents who had a child with autism delayed or declined vaccinations for a later-born child,” says Dr. Jessica Brian, a developmental psychologist at the University of Toronto. According to Brian’s research, those children who did not receive their shots on time or altogether were slightly more likely to develop autism. “I don’t want to suggest that vaccines offer some protection against autism,” she says. “But our data show that there’s no increased risk of autism among kids who are vaccinated on time.”

Brian, Smith and other vaccine researchers repeatedly point to the Internet as a source of misinformation and, in some cases, unsubstantiated fear mongering when it comes to vaccines. Not uncommon are conspiracy theories involving pharmaceutical companies and the CDC. But travel overseas, and the picture changes slightly.

In Europe, where some diseases were never eradicated as thoroughly as they were in the U.S., health officials say there isn’t as much “too much, too soon” concern among parents when it comes to immunizations. Still, European moms and dads do harbor fears about potential vaccine side effects, says Niklas Danielsson, deputy head of the vaccine-preventable diseases program for the European Centre for Disease Prevention and Control. Danielsson says the “unprecedented success” of vaccination programs has created a generation of young parents who aren’t familiar with the reality of something like a measles outbreak, so they’re focus is on a shot’s rare risks as opposed to its many proven benefits.

The lingering presence of diseases in other countries is one of the big reasons having your children vaccinated on time is so important, says Dr. Simon Hambidge, a professor of pediatrics and epidemiology at the University of Colorado. “We live in a world of international travel, and people are coming into our country all the time who may be carrying these diseases,” Hambidge says. “Unfortunately, the vast majority of the new outbreaks we’re seeing involve unvaccinated children.”

Hambidge has looked closely at one possible vaccine side effect that has parents worried: seizures. The CDC recommends that all healthy infants receive their first measles vaccination between the ages of 12 and 15 months, and some research has linked the measles vaccine to higher rates of febrile seizures. Though frightening for parents, seizures of this type are relatively common and almost never cause lasting damage, Hambidge explains. “About one in 2,000 to 4,000 kids will experience one of these febrile seizures after receiving the measles vaccine,” he says. “But we found that that seizure rate rises to one in 1,000 or 2,000 if the measles vaccine is given late, or between 16 and 23 months of age.” Hambidge says this is just one example of how a slight deviation from the CDC’s vaccination schedule can put your child’s health at risk.

“The risk of measles is far, far more serious than the risk for febrile seizures,” Hambidge says. “Even if your child is unlucky enough to have a seizure after a vaccination, these seizures are short-lived and don’t lead to any long-term issues, while measles is a life-threatening disease.”

Despite the overwhelming amount of research and real-world evidence that points to the reliable safety of vaccines, experts acknowledge that parents will continue to worry about the chemicals and additives in immunization shots. To those who have doubts, Dr. Smith says, “Vaccines are one of the most rigorously tested and effective health products on the planet. Nothing involving them is done lightly.”

And when it comes to the CDC’s recommendations regarding vaccination schedules, he adds, “As a pediatrician and as a parent, if my family’s on vacation and we have to put off my daughter’s doctor visit, I get anxious each day that she goes unvaccinated. I think the timing is that important.”

TIME Infectious Disease

Girl, 9, Killed by Brain-Eating Parasite in Water

Kansas and Florida officials issue health warnings about swimming in fresh water

+ READ ARTICLE

Kansas health and environment officials have issued a health warning after a 9-year-old girl died from a brain-eating amoeba that lives in fresh water.

Hally Yust is reported to have been a regular water-skier who frequently swam in freshwater areas. She died last week after encountering the parasite Naegleria fowleri which is found in warm, still water.

Florida officials have provided similar warnings following Yust’s death. Last summer Florida resident Zachary Reyna, 12, died after he picked up the parasite while playing in a ditch near his home.

The Department of Health and Environment in Kansas said that it’s not clear where Yust, a resident of Johnson County, contracted the parasite. This is the second such case in Kansas.

“We are very saddened to learn of this unfortunate circumstance, and our thoughts and prayers are with the family and friends during this difficult time,” said Robert Moser, Department Secretary and State Health Officer.

He added: “It is important for the public to know that infections like these are extremely rare and there are precautions one can take to lower their risk – such as nose plugs.”

From 1962 to 2013 there have been 132 similar cases reported in the U.S. The infection usually happens when the amoeba enters a person’s nose whilst they’re underwater and travels to the brain. Symptoms usually appear five days after exposure.

Officials recommend keeping your head above water when swimming in warm freshwater, wearing nose clips or avoiding freshwater activities altogether.

TIME Infectious Disease

WHO Says All Men Who Have Sex With Men Should Take Antiretroviral Drugs

A nurse takes blood for a free HIV test, during an HIV/AIDS awareness rally on World AIDS Day in San Salvador
A nurse takes blood for a free HIV test during an HIV/AIDS awareness rally on World AIDS Day in San Salvador on December 1, 2011. Luis Galdamez—Reuters

Warns of 'exploding epidemics' of HIV among gay men

The World Health Organization has suggested for the first time that all men who have sex with men should take antiretroviral medicine, warning that HIV infection rates among gay men are exploding around the world.

In guidelines published Friday, it said that it “strongly recommends men who have sex with men consider taking antiretroviral medicines as an additional method of preventing HIV infection.” Similar guidelines were issued by the U.S. in May.

Gottfried Hirnschall, the head of WHO’s HIV department, says that infection rates among homosexual men are increasing again 33 years after the epidemic hit, partially because the infection doesn’t hold as much fear to a younger generation with access to drugs that enable users to live with AIDS.

“We are seeing exploding epidemics,” Hirnschall told reporters in Geneva.

Although HIV infection rates did drop by a third between 2001 and 2012, Hirnschall characterized progress as “uneven.”

[AFP]

TIME Infectious Disease

Smallpox Virus Found in Unsecured Government Lab

Smallpox Virus Found in FDA Lab
An electron micrograph of the smallpox virus in 1975 Getty Images

Testing will reveal if the pathogens are viable

Vials containing the smallpox virus were discovered in an unused storage section of a government lab, the Centers for Disease Control and Prevention (CDC) said Tuesday.

The vials, which date from the 1950s, were discovered by National Institutes of Health workers on July 1, CDC said in a statement. The lab, based in Bethesda, Md., had been neither equipped nor authorized to store the pathogen, which was eradicated in 1978. Upon discovery, the vials were secured in a containment laboratory before being transported to another lab in Atlanta on July 7, where workers confirmed they contained DNA for the smallpox virus. There is no evidence the vials were breached, CDC said, and experts have not identified any danger to the public.

There are only two smallpox repositories in the world, under an international agreement forged in 1978 after Janet Parker, a medical photographer, died of smallpox exposure from a laboratory accident. Since then, all smallpox viruses have been destroyed or transported to either CDC’s Atlanta facility or to a research center in central Russia, where scientists can continue to research the pathogen.

The World Health Organization (WHO), which oversees the smallpox repositories, will join CDC in investigating the discovery. If the pathogens are viable — meaning they can grow tissue in culture — WHO will be invited to witness their destruction, a customary practice when smallpox viruses are found outside approved laboratories.

The U.S. discontinued routine childhood smallpox immunizations in 1972.

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