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    <recommendedItem id="20100101_19_414"
                     title="H1N1 Vaccination Still a Good Idea, CDC Says"
                     score="0.012"
                     href="http://www.medpagetoday.com/InfectiousDisease/SwineFlu/tb/18325?impressionId=1265742868529"
                     
      &lt;p&gt;Although pandemic H1N1 influenza activity appears to have leveled off, the CDC remains wary of what the future may hold.&lt;/p&gt;
&lt;p&gt;No states were reporting widespread influenza activity, and only six  --  Alabama, Georgia, Maine, New Jersey, New Mexico, and Virginia  --  were reporting regional activity, Anne Schuchat, MD, director of the CDC&apos;s National Center for Immunization and Respiratory Diseases, told reporters on a conference call today.&lt;/p&gt;
&lt;p&gt;Influenza-like activity remained below the baseline level for this time of year for the third straight week, Schuchat said.&lt;/p&gt;
&lt;p&gt;&quot;That&apos;s fairly similar to what we would normally see at this time of year with seasonal flu,&quot; she said.&lt;/p&gt;
&lt;p&gt;However, she said that the H1N1 virus continues to circulate, causing severe disease and death in some cases.&lt;/p&gt;
&lt;p&gt;Although total activity is down, Schuchat noted that the proportion of deaths attributed to either flu or pneumonia is higher than the epidemic threshold, and has been for the past three weeks. The reasons were unclear, but she said there are no indications that the virus has become more virulent.&lt;/p&gt;
&lt;p&gt;But, she said, &quot;H1N1 vaccination remains a good idea.&quot;&lt;/p&gt;
&lt;p&gt;The most recent results of the CDC&apos;s National H1N1 Flu Survey revealed that about 70 million people, or 23.4% of Americans, have been vaccinated so far. About 76 million doses of the vaccine have been used because of the requirement that children younger than 10 get two.&lt;/p&gt;
&lt;p&gt;About 37% of children up to age 18 have been vaccinated. For those younger than 10, 37% have received their second dose.&lt;/p&gt;
&lt;p&gt;Vaccine supply remains ample, Schuchat said, with about 124 million doses shipped around the country up to this point.&lt;/p&gt;
&lt;p&gt;Citing an &quot;unprecedented&quot; effort to monitor safety, she said there have not been any major safety concerns identified.&lt;/p&gt;
&lt;p&gt;&quot;So if safety was the reason that you were waiting, I think you can be reassured on that front.&quot;&lt;/p&gt;

    </recommendedItem>
    <recommendedItem id="20100101_19_343"
                     title="U.S. Marshals Seize Unapproved Ozone Generators"
                     score="0.009"
                     href="http://www.medpagetoday.com/PublicHealthPolicy/EnvironmentalHealth/tb/18228?impressionId=1265742868529"
                     
      &lt;p&gt;WASHINGTON  --  U.S. Marshals have seized 77 unapproved ozone generators, valued at almost $76,000 from a California device manufacturer, the FDA announced.&lt;/p&gt;
&lt;p&gt;The devices were advertised as treatments for various conditions, including cancer, AIDS, hepatitis, herpes, and other diseases, but lacked approval or efficacy data to support the claims made on their behalf, an FDA release said.&lt;/p&gt;
&lt;p&gt;The raid came after the company, Applied Ozone Systems (AOS) of Auburn, Calif., failed to respond to a voluntary recall request last December, the agency said.&lt;/p&gt;
&lt;p&gt;The FDA raised concerns that patients using AOS-IM and AOS-IMD devices will consider it an appropriate treatment for an affliction and delay or stop FDA-approved and proven medical treatments. Patients using the devices may risk infection from contamination of the applicator or catheter, the release said.&lt;/p&gt;
&lt;p&gt;The FDA recommended that healthcare professionals and consumers cease use of the devices.&lt;/p&gt;
&lt;p&gt;The agency said it obtained an inspection warrant for the company&apos;s manufacturing facilities after the owner refused to admit FDA inspectors. It said the inspection revealed several breaches of the FDA&apos;s good manufacturing practice requirements for medical devices, which had never been approved in the first place.&lt;/p&gt;
&lt;p&gt;Ozone is an unstable allotrope of oxygen with three atoms, instead of the normal two. Ozone generators produce ozone from oxygen and have consumer and industrial applications, but ozone itself is harmful to the respiratory system, even at relatively low concentrations.&lt;/p&gt;
&lt;p&gt;Instructions with the Applied Ozone Systems devices suggest blowing ozoned air into the rectal and vaginal areas.&lt;/p&gt;
&lt;p&gt;Friday&apos;s seizure was part of a joint effort of the FDA and the California Department of Public Health to remove or prevent unapproved or unsafe medical devices from entering the market.&lt;/p&gt;
&lt;p&gt;A statement on the company&apos;s Web site said the two ozone generator models, which sold for $750 and $1,200 respectively, were no longer available by order of the FDA and California authorities.&lt;/p&gt;

    </recommendedItem>
    <recommendedItem id="20100101_19_302"
                     title="WHO Calls H1N1 Response Imperfect"
                     score="0.005"
                     href="http://www.medpagetoday.com/InfectiousDisease/SwineFlu/tb/18165?impressionId=1265742868529"
                     
      &lt;p&gt;The World Health Organization says its response to the H1N1 pandemic could have been better, but was not unduly swayed by drug manufacturers.&lt;/p&gt;
&lt;p&gt;&quot;We are under no illusions that this response was the perfect response,&quot; Keiji Fukuda, MD, the agency&apos;s top flu expert, told a hearing being held by the Council of Europe&apos;s health committee.&lt;/p&gt;
&lt;p&gt;But he added, &quot;The influenza pandemic policies and responses recommended and taken by WHO were not improperly influenced by the pharmaceutical industry.&quot;&lt;/p&gt;
&lt;p&gt;The council&apos;s hearing is a response to criticism by some European politicians, as well as elements of the media, that the danger of the H1N1 pandemic was exaggerated, perhaps to allow drug companies to score multimillion-dollar contracts for vaccines and antivirals.&lt;/p&gt;
&lt;p&gt;In North America, many experts defended the response to the outbreak, which WHO last April declared a phase six pandemic  --  the highest level. The phases reflect that an infectious agent is widely spread and causing disease in the community, but they say nothing about the severity of the disease.&lt;/p&gt;
&lt;p&gt;&quot;I do not believe that the record supports the claim that health officials in the U.S. or WHO exaggerated the threat,&quot; said Andy Pavia, MD, of the University of Utah in Salt Lake City.&lt;/p&gt;
&lt;p&gt;Pavia said in an e-mail that health officials had a choice  --  to assume the threat was minor or to react strongly.&lt;/p&gt;
&lt;p&gt;&quot;The choice is obvious,&quot; Pavia said, &quot;and I would not want to be in a position of explaining to the families of victims why we planned for the mildest outcome.&quot;&lt;/p&gt;
&lt;p&gt;For the most part, illness caused by the disease has been mild, although several thousand people have died around the world and many more were sick enough to require intensive care.&lt;/p&gt;
&lt;p&gt;But the relatively low number of deaths has prompted Wolfgang Wodarg, MD, a German member of the council&apos;s Parliamentary Assembly, to dub the outbreak a &quot;false pandemic&quot; and call for this week&apos;s hearing.&lt;/p&gt;
&lt;p&gt;&quot;What we have experienced now is that millions of people have been vaccinated unnecessarily,&quot; Wodarg said. &quot;This is damage done to people, in order to earn money.&quot;&lt;/p&gt;
&lt;p&gt;Fukuda, on the other hand, said today the pandemic &quot;is a scientifically well-documented event.&quot;&lt;/p&gt;
&lt;p&gt;&quot;The labeling of the pandemic as &quot;fake&quot; is to ignore recent history and science,&quot; he said, &quot;and to trivialize the deaths of over 14,000 people and the many additional serious illnesses experienced by others.&quot;&lt;/p&gt;
&lt;p&gt;Utah&apos;s Pavia echoed that sentiment. Ask any front-line doctor if the H1N1 flu was mild, he said, &quot;and prepare to get your head handed to you.&quot;&lt;/p&gt;
&lt;p&gt;One of them was Daniel Hinthorn, MD, of the University of Kansas Medical Center in Kansas City, Kan. &quot;As a physician who saw many patients with this disease, I believe it was very serious in many people,&quot; he wrote in an e-mail. &quot;The threat was not exaggerated, at least to my mind.&quot;&lt;/p&gt;
&lt;p&gt;Even last month, as flu activity in the U.S. declined, he said his hospital treated 11 inpatients for the flu, including six in intensive care, while &quot;lots of others&quot; were being seen in emergency wards and clinics.&lt;/p&gt;
&lt;p&gt;On the other hand, to say the threat was exaggerated &quot;is merely to say the obvious,&quot; argued Philip Alcabes, PhD, of City University of New York City. By the time a vaccine was available, &quot;this outbreak was far less serious than feared,&quot; he said in an e-mail.&lt;/p&gt;
&lt;p&gt;But &quot;reality-based skepticism about swine flu&quot; doesn&apos;t mean that people would refuse immunization  --  not if an outbreak was a real public danger, caused by a &quot;highly transmissible agent, likely to be virulent, highly preventable with reliably effective vaccine.&quot;&lt;/p&gt;
&lt;p&gt;He warned that public health professionals must avoid &quot;falling in love with the most dire forecast and then pushing high-tech precautions against the worst-case scenario.&quot;&lt;/p&gt;
&lt;p&gt;When that happens, &quot;people have to be excused for wondering whether the officials, the media, and the pharmaceutical companies were in cahoots on swine flu,&quot; he said.&lt;/p&gt;
&lt;p&gt;But several experts argued that preparing for a worst-case scenario was the responsible thing to do.&lt;/p&gt;
&lt;p&gt;Sometimes, &quot;mother nature throws us a break,&quot; argued Howard Markel, MD, PhD, of the University of Michigan in Ann Arbor.&lt;/p&gt;
&lt;p&gt;&quot;We responded to a threat without knowing the future,&quot; he said in an e-mail. &quot;A far worse outcome might have occurred if we did not take the threat seriously and H1N1 turned out to be worse than we initially predicted.&quot;&lt;/p&gt;
&lt;p&gt;The public health response should be compared to the use of seat belts or auto insurance, according to Gregory Poland, MD, of the Mayo Clinic in Rochester, Minn.&lt;/p&gt;
&lt;p&gt;Every day, he said in an e-mail, he puts on his seat belt before driving. &quot;I don&apos;t finish each day and say &apos;What a waste, I didn&apos;t have an accident,&apos;&quot; he said.&lt;/p&gt;
&lt;p&gt;&quot;It is (and remains) unpredictable as to whether this virus could further mutate or change in a manner such that it could literally turn deadly within weeks,&quot; he said. &quot;If this pandemic had been deadly (and you don&apos;t know until you are into it) and we weren&apos;t prepared, the criticism would have been overwhelming.&quot; Poland said.&lt;/p&gt;
&lt;p&gt;He and others also noted that the flu season isn&apos;t over yet.&lt;/p&gt;
&lt;p&gt;&quot;This argument should be taking place at the end of the flu season in late March, not now,&quot; said Peter Katona, MD, of the University of California Los Angeles. &quot;Flu is unpredictable, and this is the heart of the argument.&quot;&lt;/p&gt;
&lt;p&gt;&lt;em&gt;This article was developed in collaboration with ABC News. &lt;/em&gt;&lt;img src=&quot;http://www.medpagetoday.com/upload/2009/10/1/14357_1.jpg&quot; mce_src=&quot;http://www.medpagetoday.com/upload/2009/10/1/14357_1.jpg&quot; alt=&quot;&quot;&gt;&lt;/p&gt;
    </recommendedItem>
    <recommendedItem id="20090101_19_4099"
                     title="State Report Cards Show Shortcomings in Preparedness"
                     score="-0.005"
                     href="http://www.medpagetoday.com/InfectiousDisease/URItheFlu/tb/17547?impressionId=1265742868529"
                     
      &lt;p&gt;Although states have made substantial progress in preparing for public health emergencies, the H1N1 pandemic has revealed remaining deficiencies, according to a new report.&lt;/p&gt;
&lt;p&gt;Of 10 key indicators of preparedness, 20 states achieved six or fewer; the worst performer, Montana, fulfilled only three, according to an assessment by the Trust for America&apos;s Health (TFAH) and the Robert Wood Johnson Foundation.&lt;/p&gt;
&lt;p&gt;There were seven states  --  Arkansas, Delaware, New York, North Carolina, Oklahoma, Texas, and Vermont  --  tied for the highest score of nine out of 10.&lt;/p&gt;
&lt;p&gt;The unexpected emergence of pandemic H1N1 coupled with shrinking state budgets in a crumbling economy exposed problems with the public health infrastructure, including a lack of real-time coordinated disease surveillance and laboratory testing, outdated vaccine production techniques, limited hospital surge capacity, and a smaller public health workforce, the report stated.&lt;/p&gt;
&lt;p&gt;It urged increases in funding for preparedness and efforts to solidify the public health infrastructure, even in the face of waning H1N1 activity.&lt;/p&gt;
&lt;p&gt;&quot;As the second wave of H1N1 starts to dissipate, it doesn&apos;t mean we can let down our defenses,&quot; said Richard Hamburg, deputy director of TFAH, in a statement. &quot;In fact, it&apos;s time to double down and provide a sustained investment in the underlying infrastructure, so we will be prepared for the next emergency and the one after that.&quot;&lt;/p&gt;
&lt;p&gt;The 10 indicators and how states performed in 2009:&lt;ul&gt;&lt;li&gt;Antiviral stockpiling: 13 states purchased less than half of their share of federally subsidized antivirals to stockpile for an influenza pandemic.&lt;/li&gt;&lt;li&gt;Hospital preparedness/hospital bed availability reporting: 10 states and the District of Columbia report weekly data for at least 50% of the hospitals within their jurisdiction to the National Hospital Available Beds for Emergencies and Disasters System, which is required by the Department of Health and Human Service&apos;s Assistant Secretary for Preparedness and Response.&lt;/li&gt;&lt;li&gt;Lab pickup and delivery services for public health laboratories: 13 states do not have the capacity for timely transportation of samples around the clock to an appropriate public health Laboratory Response Network reference lab.&lt;/li&gt;&lt;li&gt;Surge workforce capacity in public health laboratories: 12 states and the District of Columbia do not have enough staff to work five 12-hour days for six to eight weeks in response to an infectious disease outbreak.&lt;/li&gt;&lt;li&gt;Biosurveillance: six states do not have a disease surveillance system compatible with the CDC&apos;s National Electronic Disease Surveillance System.&lt;/li&gt;&lt;li&gt;Food safety: 14 states were not able to identify the pathogen responsible for reported foodborne disease outbreaks at a rate that met or exceeded the national average of 46%.&lt;/li&gt;&lt;li&gt;Medical Reserve Corps readiness: nine states do not meet criteria for readiness, which include the presence of a state coordinator, compliance with the National Incident Management System guidelines, and integration with the state Emergency System for Advance Registration of Volunteer Health Professionals.&lt;/li&gt;&lt;li&gt;Community resiliency as it pertains to children and preparedness: 20 states and the District of Columbia require all licensed childcare facilities to have a multihazard written evacuation and relocation plan.&lt;/li&gt;&lt;li&gt;Legal preparedness: 19 states have not adopted entity emergency liability protections or have made no formal determination under existing law.&lt;/li&gt;&lt;li&gt;Public health funding commitment: 27 states cut funding for public health from budgets from 2007-2008 to 2008-2009.&lt;/li&gt;&lt;/ul&gt;&lt;/p&gt;
&lt;p&gt;The report authors recommended that funding be restored for emergency preparedness  --  federal preparedness funds have dropped by 27% since 2005  --  to help address remaining deficiencies.&lt;/p&gt;
&lt;p&gt;They also recommended:&lt;ul&gt;&lt;li&gt;Improvements in surge capacity&lt;/li&gt;&lt;li&gt;Increased accountability and transparency of public health agencies, which should include a publicly available H1N1 after-action report&lt;/li&gt;&lt;li&gt;Improvements in community preparedness, including additional measures to reach out quickly to high-risk populations and to address disparities based on income or race&lt;/li&gt;&lt;li&gt;Development of full legal preparedness for public health emergencies at the state level, including liability protections for healthcare workers and mandates that insurance companies cover vaccines&lt;/li&gt;&lt;li&gt;Establishment of sick-leave policies&lt;/li&gt;&lt;/ul&gt;&lt;/p&gt;

    </recommendedItem>
    <recommendedItem id="20090101_19_1270"
                     title="Obama Says Swine Flu Outbreak is &apos;Not a Cause for Alarm&apos;"
                     score="-0.005"
                     href="http://www.medpagetoday.com/InfectiousDisease/URItheFlu/tb/13909?impressionId=1265742868529"
                     
       WASHINGTON, April 27 -- President Barack Obama said Monday that the emerging cases of swine flu are a &quot;cause for concern,&quot; but &quot;not a cause for alarm.&quot; 
              &lt;p&gt; 
              &lt;p&gt;The President delivered brief remarks about swine flu during a prescheduled address to members of the National Academy of Sciences here in Washington.
              &lt;p&gt; 
              &lt;p&gt;The World Health Organization is reporting there are now 40 confirmed cases of swine flu in the U.S. American health officials could not immediately be reached for comment, but the CDC has scheduled a 1 p.m. EDT press briefing.&lt;p&gt;&lt;p&gt;Most of Obama&apos;s speech dealt with his promise of an &quot;historic commitment to science,&quot; and he focused only briefly on swine flu, saying &quot;If there was ever a day that reminded us of our shared stake in science and research, it&apos;s today.&quot; 
              &lt;p&gt; 
              &lt;p&gt;The number of confirmed cases of swine flu grew from two U.S. cases to 20 in less than a week.
              &lt;p&gt; 
              &lt;p&gt;The CDC confirmed eight cases in New York, seven in California, two in Texas, two in Kansas, and one in Ohio.
              &lt;p&gt; 
              &lt;p&gt;&quot;I&apos;m getting regular updates on the situation from the responsible agencies, and the Department of Health and Human Services as well as the Centers for Disease Control will be offering regular updates to the American people so that they know what steps are being taken and what steps they may need to take,&quot; he said. 
               &lt;p&gt;
              &lt;p&gt;Meanwhile, in Canada, officials are reporting six confirmed cases of swine flu -- four high school students in Nova Scotia and two young men in British Columbia, on the country&apos;s west coast. The cases -- all linked to Mexican travel -- were reportedly mild and all the patients are recovering. None of the patients required hospital care.
               &lt;p&gt;
              &lt;p&gt;Despite that, &quot;nobody should take this for granted in any way,&quot; said David Butler-Jones, M.D., Canada&apos;s chief public health officer. &quot;It doesn&apos;t mean we won&apos;t see either more severe illness or more potential deaths,&quot; he told a news conference Sunday.
              &lt;p&gt;
             &lt;p&gt;Indeed, the outbreak is only in its early stages &quot;and there is a lot more unknown than is known,&quot; said Frank Plummer, M.D., the scientific director general of Canada&apos;s National Microbiology Laboratory in Winnipeg, which has done much of the testing of the virus for Mexico.
             &lt;p&gt;&lt;p&gt;&lt;a href=&quot;http://www.medpagetoday.com/InfectiousDisease/SwineFlu/&quot; title=&quot;Swine Flu Coverage&quot;&gt;&lt;img src=&quot;/images/swine.jpg&quot; border=&quot;0&quot;&gt;
    </recommendedItem>
</recommendedContent>
