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Health Highlights: March 23 2006

Cambodian Girl Dies of Bird Flu Reebok Charm Bracelet Linked to Child's Lead Poisoning Death Job Stress May be Actual Cause of Sick Building Syndrome Symptoms U.S. Doctors Providing Less Charity Care TB Rates at All-Time Low in U.S.

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

Cambodian Girl Dies of Bird Flu

Initial tests indicate that bird flu killed a three-year-old girl in Cambodia as that country reported its first outbreak of the virus in two years.

Seven other people with possible symptoms of bird flu and 42 other people who had contact with them are currently being tested for the H5N1 virus.

A government official said the girl became ill at her home in the western province of Kompong Speu and died Tuesday in Phnom Penh, Agence France Presse reported. It's the fifth bird flu death in Cambodia since 2003. The last human bird flu outbreak in Cambodia was in March 2004.

At least 200 chickens in the dead girl's village have died since Sunday, said an agricultural ministry official. Earlier this month, bird flu was found in several ducks in eastern Cambodia.

Since 2003, the H5N1 virus has killed more than 100 people, mostly in Asia.

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Reebok Charm Bracelet Linked to Child's Lead Poisoning Death

Massachusetts-based Reebok International Ltd. is warning consumers to discard heart-shaped charm bracelets with the company name engraved on one side because of the lead-poisoning death of a four-year-old girl in Minneapolis, Minn.

The girl reportedly swallowed a piece of the bracelet, the U.S. Consumer Product Safety Commission (CPSC) said Thursday.

The bracelet, 300,000 of which were given away free, contains high levels of lead and can cause lead poisoning and health problems in young children. Consumers should immediately take the bracelets away from children and dispose of the entire bracelet, the CPSC said.

The eight-inch long metal bracelet has a heart-shaped charm with the name "Reebok" engraved on one side of the charm. The bracelet was provided as a free gift with the purchase of various styles of children's footwear from May 2004 through March 2006.

For more information, contact Reebok at 1-800-994-6260 between 8 a.m. and 5 p.m. ET Monday through Friday.

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Job Stress May be Actual Cause of Sick Building Syndrome Symptoms

Some symptoms of so-called "sick building syndrome" may have more to do with job stress than an unhealthy workplace environment, says a U.K. study in the journal Occupational and Environmental Medicine.

The study of 4,000 civil servants in 44 buildings in London found that high job demands and low levels of support were associated with high rates of symptoms, such as coughs and tiredness. This was especially true for people with little decision-making power, BBC News reported.

The researchers aren't claiming that poor building design has no effect on workers, study co-author Dr. Mai Stafford, of the epidemiology and public health department of University College, London, told BBC News.

"But for the general workforce job stress and job demands seem to have a bigger impact. There certainly could be buildings which do have physical properties that are very bad," Stafford said.

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U.S. Doctors Providing Less Charity Care

Over the past decade, the percentage of U.S. doctors who provide free care to the poor has declined from about 75 percent to about 66 percent, according to a study released Thursday by the Center for Studying Health System Change.

The researchers said this trend, which indicates a growing problem for people without health insurance, is likely the result of stagnant government reimbursement rates and lower fees negotiated by insurers on behalf of their customers.

"In the past, a lot of physicians were able to afford (to provide free care) because they could charge paying patients higher rates," Dr. Peter Cunningham, lead researcher for the center, told the Associated Press.

Another factor is that more doctors are leaving solo practices and joining large group practices. "This means that they have less control over the types of patients they see," Cunningham said.

Rates of free care have declined across all major medical specialties since the mid-1990s, the report said. Currently, surgeons provide the highest rate of charity care (78.8 percent), perhaps because many of them treat uninsured patients in hospital emergency departments, the AP said.

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TB Rates at All-Time Low in U.S.

Tuberculosis rates reached an all-time low in the United States in 2005, but there's been an increase in the incidence of drug-resistant TB, the U.S. Centers for Disease Control and Prevention said Thursday.

The agency's Morbidity and Mortality Weekly Report said there were 14,093 TB cases reported in 2005, compared with 14,516 cases in 2004. The TB case rate in 2005 was 4.8 cases per 100,000 people, the lowest since reporting began in 1953.

However, the 3.8 percent decline in TB cases from 2004 to 2005 was one of the smallest decreases in more than a decade, the report noted.

It also said that the number of people with multi-drug resistant (MDR) tuberculosis increased 13.3 percent from 2003 to 2004, the most recent year for which data was available. MDR tuberculosis, which refers to disease that is resistant to at least two front-line therapies (isoniazid and rifampin), is difficult and costly to treat and can be fatal.

MDR tuberculosis now accounts for 1.2 percent of all TB cases for which drug-susceptibility data is available, the report said. It will be critical to monitor MDR tuberculosis trends in the coming years to determine whether the 2005 increase represents a nationwide trend and to help experts understand the implications of resistance for TB treatment and control.

In other TB-related news, the World Health Organization (WHO) said Thursday that providing the entire population of East Asia and the Pacific with access to TB treatment has led to a sharp reduction in TB-related infections and deaths.

The number of people infected with TB in 2005 was estimated to be about 500,000 less than the number infected in 2000. The annual number of TB deaths in 2004 was 40,000 less than in 2000, after the WHO introduced the DOTS (directly observed treatment, short-course) program, Agence France Presse reported.

Preliminary reports indicate that 70 percent of estimated TB cases in the region were now being detected and about 85 percent of detected cases were being treated.

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