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Health Highlights: Dec. 14, 2002

Children Are Left Out of Smallpox Directive: Officials U.S. Government Halts Test on Lung Patients Antibiotic-Resistant 'Superbug' On Rise in U.K. Push Patients to Butt Out or Risk Malpractice, NYC Health Department Warns Doctors Drug Shortages Plague U.S. Hospitals

Here are some of the latest health and medical news developments, compiled by editors of The HealthDay Service:

Children Are Left Out of Smallpox Directive, Officials Say

As the questions continue over President Bush's announced smallpox inoculation plan, a few things are becoming clearer.

Children, who have traditionally received the vast majority of smallpox inoculations, won't quality for the new vaccination program absent a bioterror attack, federal officials say.

Ethical and safety concerns bar kids from clinical trials now being conducted, which means the vaccine cannot be licensed for them, according to Dr. Anthony Fauci, who oversees vaccine development and bioterrorism programs at the National Institutes of Health.

"If Mom comes up to one of the local and state health officials and says, `I want vaccine for my 5-year-old,' currently there doesn't appear to be a mechanism for them to get it,'' Fauci said today, according to the Associated Press.

On the other hand, even though Bush has urged the general public not to get vaccinated, the shot, if you want it, will be free, The New York Times reports. But you won't be able to get it at your doctor's office.

Health and Human Services Secretary Tommy Thompson said yesterday at a news conference that the new vaccine will be provided free to Americans who want it if the vaccine, now being manufactured, passes licensing tests as expected in 2004.

But Thompson refuted other federal officials at the same conference who initially said the vaccine would be available at doctors' offices. Individual doctors would not be permitted to keep the vaccine in their offices, Thompson said, according to the newspaper report.

"We will not give it up out of our custody. It will not be willy-nilly handed out to doctors across America. We will retain custody of the vaccine," he added.

Bush's official announcement Friday said that 500,000 members of the U.S. military and others stationed in high-risk locations would be inoculated but that he had decided against initiating a vaccination program for all Americans


U.S. Government Halts Test on Lung Patients

A medical trial designed to help patients with breathing problems may actually have caused more problems.

According to the Associated Press an analysis of the test group with acute respiratory stress syndrome (ARDS) suggested that some patients faced an increased safety risk.

The trial suspension was strongly recommended by the National Institutes of Health.

The study was designed to test the use of an implanted catheter to monitor how much fluid was building up in ARDS patients. The fluid level is particularly important because ARDS is caused by infection, pneumonia, trauma or chronic conditions, according to the AP. Between 30 percent and 50 percent of ARDS patients die, according to the U.S. government, causing an estimated 50,000 deaths annually

The problem with the clinical trial appears to have occurred because of different pressure levels in ventilators used by the ARDS patients. As a result, researchers weren't certain which deaths may have happened because the ventilators created too much or too little pressure as they assisted the patients in breathing.


Antibiotic-Resistant "Superbug" On Rise in U.K.

A new strain of the staphylococcus bacterium -- found in almost every hospital around the world -- has British scientists worried.

The BBC reports that the "superbug" methicillin-resistant Staphylococcus aureus (MRSA) is responsible for an increasing number of deaths during the past nine years, according to researchers.

And the numbers, while small, are dramatic. The number of death certificates that mentioned MRSA as the cause of death increased from 13 in 1993 to 114 in 1998. The reason: MRSA has built up resistance to antibiotics commonly used in hospitals.

There's more disturbing news. The BBC also says that Scottish doctors have reported a case of "GISA" -- a strain of Staphylococcus that has developed even more resistance to antibiotics.

But officials say that many of the deaths could have been prevented merely by better hygiene, such as hospital staff washing their hands more often. Claire Rayner of the Patients' Association is quoted as saying that modern antibiotics had made hospital staff complacent. "The presence of antibiotics has made people lazy," she told the BBC.


Push Patients to Butt Out or Risk Malpractice, NYC Health Department Warns Doctors

New York City doctors may be charged with malpractice if they don't push patients to butt out, according to the NYC Health Department's quarterly newsletter.

Physicians say they are stunned by the department's warning and have never heard of a lawsuit being filed against a doctor for not coming down hard on patients who smoke, the New York Post reports.

The newsletter states that: "Because physician intervention can be so effective, failure to provide optimal counseling and treatment is failure to meet the standard of care and could be considered malpractice!"

Scott Einiger, legal counsel for the New York County Medical Society, said while doctors are obliged to help patients with addictions, the suggestion that they be sued unless they provide treatment plans for quitting smoking, sets "an impossible standard."


Drug Shortages Plague U.S. Hospitals

U.S. hospitals are facing medication shortages, particularly of injected drugs, primarily because fewer drug companies are willing to manufacture the drugs and vaccines that, while indispensable, yield low profits, experts say.

In some cases, sole manufacturers of some drugs decide to stop production, which increases the demand. Other times, aging manufacturing plants no longer pass sterility tests and close down temporarily, the Associated Press reports.

Hospital pharmacists say shortages rarely harm patients. But, according to the American Society of Health-System Pharmacists, last year three patients in the San Francisco-area died of bacterial meningitis from a contaminated steroid drug. Their doctor, unable to get the injectable solution, had it compounded at a local pharmacy.

George Hartpence, director of pharmacy services at the New Jersey Hospital Association, said in the 80's and 90's it was considered a problem if one or two drugs were on backorder. Nowadays, "at any given time, it seems there are about four dozen drug items that are near impossible to get," he said.

Dr. Mark Goldberger, the U.S. Food and Drug Administration's drug shortage coordinator, predicts the situation won't improve any time soon. He said the agency is trying to alleviate the problem by investigating alternate sources, letting troubled plants stay open under closer supervision, and permitting the importation of drugs from other countries.

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