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Swine flu, the mammogram controversy and a Hopkins' scientist becomes among just a handful of women to win the prestigious Nobel Prize for medicine. Check out our top 10 health stories of 2009.
Anything we're missing? What's your top 10? Or, if you rather, what's your top 10 overblown stories of 2009? Let us know. And Happy New Year!
AFP/Getty Images
New Year's is upon us and many people will no doubt be mixing some drinks to celebrate.
But one local expert is warning not to mix alcohol with energy drinks. It's dangerous, says Mike Gimbel, director of Powered by Me!, a St. Joseph Medical Center program for training and educating people on steroids and other performance enhancers.
Energy drinks are stimulants and alcohol is a depressant, and that sends dangerous mixed messages to the nervous system, he says. The stimulant effets can mask how drunk people are because fatigue is one of the normal ways to tell. They may also believe they aren't that impaired and drive. But they are just as drunk.
Gimbel says that energy drinks will not sober up a drunk. Neither will coffee, for that matter. Only time can do that.
Baltimore Sun file photo/Doug Kapustin
Millions of people take vitamin supplements and among the most popular is ginkgo biloba, with a reputation for boosting concentration, memory and even thwarting dementia.
But the popular herb has been proven to do none of those things, according to a new study appearing in the Journal of the American Medical Association.
The study is being called the largest clinical trial to date on the plant extract's value in slowing cognitive decline.
In the study of some 3,000 people ages 72 to 96, half received doses of 120-mog ginkgo extract twice a day for about six years. The other half got a placebo. The team of researchers didn't find any difference in memory language or attention and saw no differences in effects by age, race or education.
It isn't surprising. Last year, a comprehensive clinical trial concluded that supplement is not effective in prolonging or staving off Alzheimer's. An accompanying editorial said taking the supplement won't help and could possibly cause harm.
It's not just ginko biloba whose medical benefits have been questioned. The jury's still out on a host of supplements. Yet Americans spend billions every year on them.
Do you? What do you think?
AFP/Getty images
The maker of Tylenol Arthritis Pain medicine is expanding a voluntary recall after reports that the caplets had a moldy smell, triggering nausea, dizziness and stomach pain.
First off, all reports of problems were temporary and not serious, says the Food and Drug Administration.
Still, the recall affects all lots (increased from just five last month) of the 100-count bottles of caplets with the red EZ open cap. The foul smell is caused by trace amounts of a chemical called 2,4,6-tribromoanisole, used to treat wooden pallets that store packaging materials, the FDA said late Monday.
If you've bought the medicine and would like a refund, contact the company at 1-888-222-6036.
If you've taken this medicine and had an adverse reaction, you can report it to the FDA here: www.fda.gov/medwatch.
Frustrated by the mounting deaths from H1N1 flu, Brazilian researchers say they have begun studying the precise causes of death in victims.
"The lack of information on the pathophysiology of this novel disease is a limitation that prevents better clinical management and hinders the development of a therapeutic strategy," said lead author Dr. Thais Mauad, associate professor of the Department of Pathology at São Paulo University.
The results of their study will be published in the Jan. 1 issue of the American Thoracic Society's American Journal of Respiratory and Critical Care Medicine.
The researchers examined 21 confirmed H1N1 patients who died in July and August, mostly between 30 and 59. Three-quarters had underlying medical conditions, including heart disease and cancer. But the rest had no clear condition, yet still died of a progressive form of the disease.
Researcher knew that most who survive swine flu have fever, cough and achiness. But most who die had difficulty breathing and less fever and achiness.
They all died of severe acute lung injury. But they also all had distinct patterns of damage in their lungs, and researcher said that meant the infection killed in distint ways. Some had bacterial co-infections and some had a hemorrhagic condition.
Some of those who died also had an aberrant immune response in their lungs. This "suggests that an overly vigorous host inflammatory response triggered by the viral infection may spill over to and damage lung tissue, thereby causing acute lung injury and fatal respiratory failure," said Dr. John Heffner, past president of the ATS.
Most people survive the flu with no lasting issues, and further research is needed to understand how and why some people die. This research lays the groundwork by defining the patterns of a fatal infection, the doctors said, and could lead to future treatment.
AFP/Getty photo of Brazilian man holding an X-ray of his lungs
The Center for Science in the Public Interest, a nonprofit health advocacy group, has put out a new report that finds there has been a decline in foodborne outbreak investigations by state health officials.
The report, in the latest Outbreak Alert, says there were fewer investigation in 2007 than in the previous decade, and researchers concluded that this may be because of a gap in state public health spending.
States reported 33 percent fewer fully investigated outbreaks -- two or more illnesses linked to the same food -- to the Centers for Disease Control and Prevention in 2007 than in 2002. The researchers say there are not fewer outbreaks: The state reported almost 1,100 outbreaks in 2007 but they only identified both a food and a pathogen in 378 cases. That means a complete investigation.
With less information on potentially troublesome foods, the CDC and the state have less ability to identify problems early in the food system and less ability to issue recalls.
The group is pushing for legislation that would create a food-safety system focused on preventing contamination. Food processors would have to prepare food safety plans and the FDA would have to inspect more frequently. The legislation would also provide for better coordination between states and the federal government. The House has passed the bill but the Senate has not.
CSPI looked at 4,638 outbreaks, involving 117,136 individuals, linked to specific foods, that occured between 1998 and 2007. The main culprits were seafood (838 outbreaks), produce (684 outbreaks), poultry (538 outbreaks), beef (428 outbreaks), pork (200 outbreaks).
The FDA oversees most of the foods, including seafood, produce, eggs and dairy products. The Department of Agriculture regulates meat and poultry. Eggs improved their record considerably in the last decade that the group has been tracking illnesses, probably because of new safety programs by egg producers required by FDA. But dairy made more people sick, probably because unpasteurized products became more available after 2004.
The group says this is still a big problem and cites CDC numbers estimating contaminated food kills thousands a year and sickens another 76 million. Most aren't reported, and according to this report, many of the others go without full investigation.
AP photo of what left of the bagged spinach linked to a foodbourne outbreak in 2006
The state Department of Health and Mental Hygiene has collected a list of more retail outlets that are offering the H1N1 vaccine. The state says everyone can now get the shot, not just those in the priority groups, though they should get a vaccination if they haven't (health workers, pregnant women, infant caretakers, those with chronic conditions and kids)
So, if you have some free time over the holidays, want to get a shot and don't want to bother with a doctor's appointment, here some other venues are below. Be sure to check wtih specific stores for hours and availability.
Also, residents can call 211 for help locating pharmacies which are vacicnating. They have phone numbers of the pharmacies, too.
Or, go to http://www.flu.maryland.gov for a map and more information.
More are expected to offer the vaccine, but the chain stores confirming they are vaccinating against the H1N1 (swine) flu now include:
--Selected CVS stores, locations with Minute Clinics only
--Selected Rite-Aid Pharmacies
--Selected Walgreens Pharmacies
--Selected Kmart stores
--Target Clinics, but not all Target Pharmacies just yet
--Shoppers Pharmacies
--Selected Safeway grocery stores, with pharmacies
Photo by AFP/Getty Images
Santa's got a big gut. It's part of Old St. Nick's jolly appeal. But it is NOT a good public health image, so says an Australian researcher who advises Father Christmas to lay off the fattening food and swap his sleigh for a bike or better yet, just walk.
Is he joking? Seems like it. Images of Santa promote obesity, driving under the influence, speeding and a generally unhealthy lifestyle, writes Dr. Nathan Grills of Monash University in Australia, in the article appearing in the British Medical Journal.
UPDATE: See our later interview with Grills, who says his article was a Christmas spoof.
A boozing Santa is news to me. Apparently down under Santa takes a few swigs of brandy before he sets off to his next house. After visiting a few, well, billion homes, he could get mighty tipsy, says a release for the article. As far as speeding, is there much traffic in the skies on Christmas Eve? I wonder.
Anyhow, Grills thinks Santa needs an image overhaul, with a healthy lifestyle that kids can look up to.
"Santa sells, and sometimes he sells harmful products" according to Gills in a statement. "Like Coca-Cola, Santa has become a major export item to the developing world."
While Santa has been banned from smoking, you can find images of him puffing a pipe on holiday cards. Naughty Santa!
If all that wasn't enough, Grillls calls Santa's a germ magnet and has the potential for spreading -- you guessed it -- swine flu. Well, we've already told you about Santa's quest for an H1N1 shot, so hopefully he's checked that off his Christmas list.
AP photo
Tis the season of temptation -- food temptation, that is. If your office is anything like ours, you've been inundated with sweets galore. At our holiday potluck breakfast, my dear coworkers actually had the nerve to bring super-rich brownies, sugary danishes and the most decadent chocolate cake I've ever tasted. Sigh.
Well, you don't have to succumb to the pressure. There are ways to eat healthy around the holidays. My inbox is flooded with tips from health gurus. Here's a sample of the best ones:
From the University of Maryland Medical Center:
Enjoy treats, but be choosy. For each meal, pick a few favorite items and stick to them rather than trying everything.
Eat regularly during the holidays – don’t starve yourself. When you save all those calories for that big party you're more likely to overeat.
Choose nutrient-rich rather than high-calorie foods. The more colorful the vegetable, the more heart-protective antioxidants it contains.
Battle the bulge. Beverages or foods that contain alcohol, chocolate, caffeine, peppermint, spearmint, coffee, carbonation, and acidic fruits and vegetables can trigger heartburn or acid reflux.
From cancer center dieticians at University of Michigan:
Eat smaller portions. This is especially important at a buffet, where you may want to try everything. Instead, choose the items you want to try the most, and eat a little of each.
Pace, don’t race. Many times, people eat so fast that their stomachs don't have enough time to register they’re full. Eat slower, savoring each bite and chances are you'll eat less.
Bring a low-calorie dish to holiday parties. Your host will appreciate it and you'll know that at least one healthy item will be on hand.
Be physically active. Look for ways to incorporate some daily physical activity during the holidays. Enjoy a brisk walk. Exercise can be a big stress reliever.
And here's my personal favorite: Be realistic. Don't try to diet during the holidays. Set a goal to maintain your weight.
The holidays can be especially hard for people with conditions like diabetes or celiac disease. Folks at the University of Maryland suggest diabetics carry their glucose meter with them and check their glucose half way through a holiday party.
For celiac disease, where people cannot tolerate gluten, a new website called Gling offers a host of great tips, recipes and coping techniques. It also aims to provide an online community for people adopting a gluten-free lifestyle.
There are lots of assumptions made about the U.S. health care system and how it differs from say, the British nationalized model. In America, everyone has unfettered access to top-notch drugs, while the Brits ration their care, goes the stereotypes. That leads many critics of U.S. health reform efforts to assume the American system is just fine the way it is.
But a new study by Johns Hopkins researchers finds the perceptions aren't so. The study compares the two systems' access to the most expensive cancer medications and asks: Which is more fair? And which cancer patients are better off?
The study, appearing in Milbank Quarterly, compared the costs of 11 pricey cancer drugs. In the UK, seven are free to all patients, with no out-of-pocket costs. Four aren't because they aren't considered worth the limited benefit. If patients want those drugs, they need to pay up.
Here at home, people with insurance have some coverage of all 11 drugs--but the range of out of pocket costs are enormous, depending on the carrier.
Both systems involve a kind of rationing, concludes the study. And here's something that will make reform foes gasp: The issue isn't whether rationing is good or bad, argues the reports' author, Ruth R. Faden, director of the Johns Hopkins Berman Institute for Bioethics. That's because no system can provide patients every medication or intervention to every patient all the time, she writes.
"The issue is what we should do about extraordinarily expensive treatments, some of which do very little to improve how well or how long people live," said Faden in a statement. At the same time, she adds, "there is no ethically defensible reason why some Americans have access to expensive cancer drugs and some do not."
The British system seemed fairer and better able to deal with those wrenching end of life decisions, the authors found.
It's a thorny predicament -- but one every health care system needs to confront: who gets what drugs? Who gets denied? And how to deal with these decisions toward the end of life?
"We're managing health care costs by not allowing some people to be treated at all or forcing them to face financial ruin by getting treatment," Fade says. "Who has an extra $100,000? That's why people sell their homes. That's why people's kids don't go to college. There's probably no more anguishing kind of decision than what a patient and her family face at the end of life."
For all you Marylanders still trying to find your driveway after the weekend's record-breaking blizzard, be safe -- especially if you've got a fancy new snow blower.
The Curtis National Hand Center at Union Memorial Hospital in Baltimore saw 10 patients over the weekend with traumatic hand injuries from snow blower accidents.
Some of the center's most challenging hand reconstruction surgeries come from snow blower injuries, said Debra Schindler, a Union Memorial spokeswoman.
Schindler passes on these tips to keep in mind while you're digging out:
• Stop the engine and use a long stick to unclog wet snow and debris from the machine. Never use your hands to unclog a snow thrower.
• Always keep hands and feet away from all moving parts.
• Never leave the machine running in an enclosed area.
• Add fuel to the tank outdoors before starting the machine; don’t add gasoline to a running or hot engine. Always keep the gasoline can capped, and store gasoline out of the house and away from ignition sources.
• If you have an electric-powered blower, be aware of where the power cord is at all times.
Even if you don't have powerful snow removing tools at your disposal, remember, shoveling snow has its own risks. The one death blamed on Saturday's storm was a man who died of a heart attack while shoveling. (Shoveling snow is actually a known trigger for heart attacks.)
Here are some tips from the American Academy of Orthopaedic Surgeons on preventing shoveling injuries. Stay safe -- and warm!
Baltimore Sun photo
The U.S. Environmental Protection Agency has honored six Maryland hospitals for what they call their environmental leadership and commitment to pollution prevention efforts.
The Trailblazer Award recognizes hospitals across the region -- Delaware, Maryland, Pennsylvania, Virginia, West Virginia, and Washington -- that have stepped up their sustainable practices.
“These hospitals are successfully demonstrating leadership and innovation in reducing their environmental footprint,” said Virginia Thompson, sustainable healthcare sector manager for the mid-Atlantic region of EPA, in a statement. “They have undertaken a challenging task and have produced measurable results in many cases, demonstrating what can be accomplished when hospitals take advantage both of senior executive support and grounds-up initiative from across the hospitals’ many departments.”
Local honorees (in EPA's words):
--Franklin Square Hospital Center in White Marsh, which developed holistic, sustainable policies that will serve as a foundation for the entire MedStar Healthcare System.
--Baltimore-based LifeBridge Health, which adopted a corporate-wide set of waste management policies, instituted environmentally preferable purchasing practices, and implemented a food waste reduction and composting program.
--The University of Maryland Medical Center in Baltimore, which established a university farmers’ market and is reducing greenhouse gases by providing opportunities for patients, staff, and the community to purchase locally grown food.
--The VA Maryland Health Care System in Baltimore and Perry Point, which has an environmental management system and is using it to guide environmentally preferable purchasing decisions, reduce energy and water use, purchase local foods, and develop written procedures for minimizing the purchase and use of hazardous chemicals.
EPA also honored Maryland Hospitals for a Healthy Environment (MD H2E), which officials said has gotten hospitals in Maryland to up their sustainability and reduce their environmental footprint. The Maryland Department of the Environment has supported MD H2E with grants for mercury and PVC audits at seven hospitals and is now helping fund energy audits at two Maryland hospitals.
For more information on Maryland Hospitals for a Healthy Environment, click here. And for info on EPA Sustainable Healthcare, go here.
Other honorees are:
--Atlantic General Hospital in Berlin, which implemented performance contracting, resulting in energy and water conservation, and publicized the program both internally and externally.
--Montgomery General Hospital in Olney, which has reclaimed wetlands to reduce stormwater runoff, and which has a hospital representative serving on the county solid waste advisory committee.
Now that state health officials have decided to make H1N1 vaccinations available to everyone, CVS's MinuteClinics around Baltimore have begun offering H1N1 flu, as well as seasonal flu, vaccinations seven days a week without an appointment.
You can get both shots at the same time.
Unlike most city and county clinics offering H1N1 and seasonal flu shots, the MinuteClinics are charging. But check with your insurance company to see what you'll have to pay. Medicare and most major insurance cards are accepted at MinuteClinic. (And also check with your doctor, because more of them, and more retail outlets are also getting the vaccine.)
To see if your MinuteClinic has vaccine, go to www.minuteclinic.com.
To look for city and county clinics go to flu.maryland.gov.
With supplies of H1N1 flu vaccine limited, the Centers for Disease Control and Prevention had placed priority on young children, those with underlying health conditions, pregnant women, those caring for infants and health care workers. But now that there is more supply and the beginning of a lull in illnesses, the CDC recommends that others get the vaccine, too.
Flu season last until May, and another wave of illnesses is expected. As for seasonal flu, that usually hits hard in January. Seniors and those with underlying health conditions are generally hit hardest by seasonal flu, which generally kills 36,000 a year.
We're never surprised by the attitudes of teens, but new research has us at Picture of Health scratching our heads.
On one hand, it's good news for the work that public health officials have put into anti-smoking campaigns. Nearly 70 percent of kids 12 to 17 years old said there was a great risk from smoking one or more packs a day.
But only 40 percent said there was a great risk from binge drinking (defined as five or more drinks once or twice a week) and just a third perceived a great risk from smoking marijuana once a month. And just about half said there was a great risk in using cocaine once a month or LSD once or twice.
The findings, from the Substance Abuse and Mental Health Services Administration, are based on responses from nearly 50,000 12 to 17-year olds participating in a national survey.
They bolster the government's annual report of teens drug and alcohol use released earlier this week that found teen cigarette smoking is down to the lowest level since 1975. At the same time, though, marijuana use is growing and prescription drug use remains high.
University of Michigan researcher Lloyd Johnston, who oversaw that survey, told the LA Times that kids underestimate the risks of LSD, inhalants and Ecstasy. It's a sign that "a new generation of kids are interested . . . in rediscovering these drugs, because they don't understand why they shouldn't be using them."
AP photo
Despite the risk posed to mother and baby, early births -- both by elective c-section and induction -- are on the rise.
But many women aren't completely aware of the potential harms of giving birth too soon -- especially when there is no medical need, according to a new study by United Health Care on women's attitudes toward the safety of early births.
Even though the American College of Obstetrics and Gynecologists (ACOG) recommends scheduled deliveries take place after a woman's pregnancy has reached 39 weeks (of a 40 week pregnancy) a little more than half of women surveyed think it's safe to deliver before 37 weeks.
Despite the warnings, rates of births between 34 and 36 weeks are increasing, the report says. The risks are real: studies show babies born that early are more likely to have medical problems.
The authors suggest that doctors are planning births to fit their schedules or that of their patients -- overlooking safety concerns. Patients' misconceptions of the risks might be fueling their decision to request a c-section, the authors said.
With more than 1.3 million c-sections performed every year in the U.S -- there's growing concern about this trend. A study in the New England Journal of Medicine found between 1999 and 2002, nearly 36 percent of elective c-sections were done before 39 weeks. As this piece explains, repeat elective c-sections done before 39 weeks, doubles a baby's risk of respiratory problems.
Attitudes about the issue vary and can become heated on internet chat rooms, where moms-to-be pointedly argue the pros and cons of elective c-sections.
It's an ethical dilemma for doctors and patients, says ACOG. There are many occasions where c-sections are necessary and can save the life of a woman and her baby. But when not a medical necessity, women, providers and hospitals need to be better educated on the risks, the authors write.
Now for a little football departure. (We're quite versatile here at Picture of Health)
No one expects Ravens fans to root for the opposing team. But during this Sunday's match up with the Chicago Bears, perhaps Baltimore fans can take a little comfort in touchdowns scored by their rival.
For every touchdown Bears quarterback Jay Cutler completes, drugmaker Eli Lilly and Company will donate $1,000 to the summer camp scholarship fund of the American Diabetes Association. Cutler, who has type 1 diabetes, has been raising awareness of the illness through the Touchdowns for Diabetes program. So far this season, some $48,000 has been raised.
With the Senate in a pinch to meet a Christmas deadline to pass a health reform bill, a new report paints a bleak picture for Maryland if reform doesn't happen.
Some 482,000 people in Maryland will gain coverage by 2019 under the Senate health reform bill, according to the report by the national consumer advocacy group Families USA. Without it, about 125,000 people in Maryland will lose coverage by that same date.
In 2007 and 2008, the average number of uninsured in Maryland was 715,000, but that figure could rise to 840,000 if the Senate goes home for Christmas without a bill, the report estimates. Nationally, the number of people without insurance could hit 54 million in 2019 without a health care overhaul.
The group, which if you haven't noticed, has been lobbying big time for the Senate to hurry up and pass legislation to expand coverage to millions. It has come out with similar sobering figures on the impact that the status quo could have on the states.
A few months ago, the group released a report estimating that 114,780 people will lose health coverage in Maryland from 2008 through December 2010.
photo courtesy of Brooks Elliot @ flickr
New research puts a number on the cancer risk that the growing number of CT scans can pose patients -- the latest evidence that the scans may be overused.
The 70 million CT scans done in 2007 -- a jump from just 3 million in 1980 (!) -- could ultimately cause 29,000 new cancer cases, according to estimates from the study, which appears in the latest Archives of Internal Medicine.
Doctors like the scans because they provide super-clear pictures inside the body. Their use has transformed medicine, allowing earlier diagnoses and treatment. But the research, the latest among several papers of late to raise doubts about whether CT scans make people healthier, suggests the imaging can do more harm than good.
We've written before about not only the potential dangers of excessive imaging -- but how it contributes to skyrocketing health care costs. Those scans are pricey and can bring in big money to doctors practices, hospitals and imaging centers.
At a time when the nation is trying to rein in health care costs, could more prudent use of CT scans help?
An editorial appearing with the study takes on the issue of costs:
A recent Government Accountability Office report on medical imaging, for example, found an 8-fold variation between states on expenditures for in-office medical imaging; given the lack of data indicating that patients do better in states with more imaging and given the highly profitable nature of diagnostic imaging, the wide variation suggests that there may be significant overuse in parts of the country.
As far as the cancer risk is concerned, imaging experts say they are looking at ways to reduce a patient's radiation exposure. At Union Memorial Hospital in Baltimore, a CT Radiation Reduction Project studies ways to reduce the use and exposure to our patients. There's also efforts to use software to "tailor" the amount of radiation used per patient.
Baltimore Sun photo
Vaccine maker Sanofi Pasteur is recalling 800,000 doses of a children's H1N1 vaccine after tests showed the vaccine had lost some of its strength.
About 10,300 doses of the pre-filled syringes have gone out to 48 providers in Maryland, according to the state Department of Health and Mental Hygiene. The pre-filled syringes, designed for children 6 months to 3 years old, are popular with doctors' offices because they are convenient and lack the preservative thimerosal, said David Paulson, a health department spokesman.
The recalled vaccine comprises nearly 12.8 percent of the nearly 79,900 pre-filled syringes for children distributed around the state. So far, Maryland has received some 1.8 million doses of the swine flu vaccine.
None of the recalled vaccine was used by local health departments in their numerous clinics this fall.
The state health department is sending emails to providers alerting them of the recall and is awaiting further instruction from the Centers for Disease Control and Prevention.
The CDC says despite the reduced potency, children who have already been vaccinated with this shot, do NOT need to get vaccinated again. The vaccine, even in reduced strength, should provide enough protection.
Here's more information, including a Q&A from the CDC on the issue.
AP photo
A Johns Hopkins-affiliated international health organization received a $22.9 million grant today from the Gates Foundation to educate and increase contraceptive use in Kenya's slums. Jhpiego, a nonprofit that has worked for 35 years to improve public health for women and families around the globe, will use the grand money to expand its work with urban poor and reproductive health.
With Kenya's slums struggling with staggering rates of HIV/AIDS and sexually transmitted diseases, the goal if the project, called the Gates Kenya Urban Reproductive Health Initiative, is to increase contraceptive use by 20 percent.
Rates of contraception use are poor in Kenya's slums, even when public health clinics are within walking distance, Jhpiego reports. Lack of trust of public health workers and the high cost of health services keep many people away. Some 39 percent of poor urban Kenyans are not using contraceptives, according to Jhpiego.
Read more about Jhpiego's work and how it's linked schools in Baltimore with those in Africa to improve health.
An annual study of public health preparedness ranked Maryland in the middle of the pack in its readiness. The state scored 7 out of 10 on the key indicators.
Called "Ready or Not? Protecting the Public's health from Diseases, Disasters, and Bioterrorism" report, the report was released today by the Trust for America’s Health and the Robert Wood Johnson Foundation. It said this year, the H1N1 flu outbreak exposed serious gaps in the nation’s ability to respond to public health emergencies.
This year, economic crisis is putting more pressure on the already fragile public health system.
The researchers used publicly available data and interviewed public health officials. They concluded that 20 states scored six or less out of 10. Nearly two-thirds of states scored seven or less. Seven states tied for the highest score of nine out of 10. Montana had the lowest score at three out of 10.
“The H1N1 outbreak has vividly revealed existing gaps in public health emergency preparedness,” said Richard Hamburg, Deputy Director of the trust. “The Ready or Not? report shows that a band-aid approach to public health is inadequate. As the second wave of H1N1 starts to dissipate, it doesn’t mean we can let down our defenses. In fact, it’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.”
The report authors wouldn't say what was a passing grade, but said that funding, long a problem, is a special problem this year and most states cut money -- including Maryland.
Maryland did:
-purchase 50 percent or more of its share of federally-subsidized antiviral medications to prepare for a potential pandemic flu outbreak,
-submit data on available hospital beds weekly for at least 50 percent of the facilities within the state to the U.S. Department of Health and Human Services during the 2009 H1N1 response,
-ensure its public health lab has the capacity in place to assure the timely pick-up and delivery of disease samples on a 24/7, 365 day basis,
-report its public health lab has enough staff to work the intense hours needed during an emergency, like H1N1 (five, 12-hour days for six to eight weeks),
-track diseases through an Internet system used by the CDC,
-not identified the pathogen responsible for reported food-borne disease outbreaks at a rate that met or exceeded the national average of 46 percent (combined data 2005-2007).,
-meet the Medical Reserve Corps readiness criteria for medical volunteers during an emergency,
-require all licensed childcare facilities to have a multi-hazard written evacuation and relocation plan for emergencies,
-not have a law or legal opinion in place to limit liability against organizations that provide volunteer help during emergencies,
-not increased or maintained level of funding for public health services from FY 2007-08 to FY 2008-09.
Report authors recommend states: ensure stable and sufficient funding, conduct an H1N1 after-action report and update preparedness plans with lessons learned, increase accountability and transparency, improve community preparedness.
UPDATE: Here's a response from the John M. Colmers, the secretary of the state Department of Health and Mental Hygiene:
"While Maryland's 'report card' score improved dramatically what's really important are our everyday real-life efforts to protect public health. A realistic scoring would put us at the top of the class, 90 percent or above. We're proud of what we do and how we do it, especially given our preparedness and response to the most significant public health issue in recent years; H1N1 (swine) flu.
We dispute their findings which incorrectly and arbitrarily dismiss Maryland's extensive efforts to protect the public against food-borne illness and limit legal liability during a public health emergency. These are points we raised directly with the study's author."
If there isn't enough to watch out for, a new study from Children's Hospital Boston’s Division of Emergency Medicine shows that holiday decorations, particularly glass ornaments, can be a safety hazard.
Records there show an average of five ornament-related injuries per year. More than half involve children eating fragments of these decorations, as well as batteries and pieces of glass.
“Parents need to be vigilant during the holiday season, even though it’s also a busy time of year,” says co-author Dr. Lois Lee, of Children’s Division of Emergency Medicine and director of the hospital’s Emergency Department Injury Prevention Program. “If you know that your child has a tendency to put things in his or her mouth, you should be especially careful.”
The study, which looked back at hospital records, was published in the December 2009 issue of Pediatric Emergency Care.
Out of a total of 76 cases:
-56 percent involved ingestion or taking fragments of ornaments or light bulbs into the mouth and more than a quarter of these injuries resulted in bleeding of the mouth or gastrointestinal tract;
-27 percent of cases involved lacerations; more than two-thirds of lacerations required surgical repair;
-85 percent of cases required radiological screening;
-three patients were examined for potential toxin exposure;
-two patients experienced minor electrocution;
-one case of ingestion involved an ornament not made of glass.
Because so many kids get hurt, researcher recommend health care professionals talk to parents about their decorations. They suggest keeping toddler away from the Christmas tree by putting a gate around it or keep ornaments off lower branches. And make sure the tree won't easily fall over on someone.
Anyone else have suggestions to keep things merry this time of year?
Associated Press photo of glass ornaments
Just last week, the American Medical Association loudly objected to lawmakers' proposal to expand Medicare because, it insists, the federal insurance doesn't pay enough as it is.
Not all doctors agree with the AMA. In fact, in this Op-Ed published yesterday in The Sun, a group of Hopkins doctors-in-training say they would gladly accept lower salaries if it would ensure "universal, quality care for our nation."
The six authors take issue with health care's current fee-for-service model, paying physicians for each test, procedure and visit they provide.
That system "rewards specialty care while marginalizing sensible primary care, mental health and preventive medicine" the authors write. Doctors don't get reimbursed for coordinating care for chronic conditions, even though managing such disease is vital for a patient's care, they say. Salaries, which remove such incentives are the way to go, they insist.
We realize the idealism of our goals. We do not expect to donate our services or to work for fees that fail to compensate us for the extensive training we now pursue. We also realize we are asking for nothing less than an overhaul of the health care system. Nonetheless, all of us, whether bound for specialty practice, academic medicine or primary care, are committed to health care reform that places patients first.
Just a bunch of starry-eyed kids, you say? Well, they aren't the first to object to the fee-for-service model.
Others have argued the system only encourages more testing and higher health care costs.
The Wall Street Journal's Health Blog writes about how Massachusetts is experimenting with alternative payment systems.
And this NYT magazine piece points to the fee-for-service model as the root of the problem in health care and profiles a doctor in Salt Lake City, Utah trying to reshape his hospital's system. While Congress may be unlikely to take on this issue in its reform efforts, doctors can do their part to change the system, the story explains.
Baltimore City has opened up the H1N1 flu vaccine clinics to all comers, and this reporter got her shot today. I already got the seasonal flu shot. As someone who frequents emergency rooms, doctors' offices and other places where there are all kinds of bugs, I thought I shouldn't take any chances or waste any time getting some protection.
I went to the main library on Cathedral Street and it was a packed house. They were offering both H1N1 and seasonal shots for free to residents. I was #422 and I got there at noon. That was just halfway through the 10 a.m.-2 p.m. clinic (though the workers said they were surely staying until 3 or 4). But the line moved. I was there a little over an hour, including a few minutes of standing around time afterward to make sure I didn't have an allergic reaction. I didn't. In fact, I feel nothing at all. I think that's good.
There are some more city clinics planned by the Baltimore City Health Department:
-Saturday, Dec. 12: Coppin State University, Health and Human Services Building, 2601 W. North Ave., from 11 a.m.-3 p.m. Limited onsite parking is available.
-Tuesday, Dec. 15: Zeta Center, 4501 Reisterstown Road (21215), from 3 p.m.-8 p.m.
-Friday, Dec. 18: Waxter Center for Senior Citizens, 1000 Cathedral St. (21201), from 10 a.m.-2 p.m.
-The Bureau of Immunization will continue to dispense flu vaccine at two standing immunization clinics: Eastern Health District Center, 620 N. Caroline St., and the offices, located at 1800 N. Charles St. (6th floor).
The state now has ordered almost 1.6 million doses of the H1N1 flu vaccine and seems to finally have enough to go around. For those not living in the city, go to www.flu.maryland.gov for a list of local health departments and their clinics.
Maryland's former Lt. Gov. Kathleen Kennedy Townsend takes aim at American Catholic Bishops' support of restricting abortion funding in health care reform legislation.
In this fiery Op-Ed in the Politico, published just before the Senate defeated an amendment this week that would place new abortion restrictions in the health care bill, she lashes out at bishops she says have "lost their way."
Why is it that the bishops are more concerned with restricting millions of American women from making health care decisions that are best for them and their families than they are with ensuring that millions of Americans — women, men, children, immigrants, the poor, the middle class — get much-needed health insurance?
As a Catholic and neice to the late Sen. Ted Kennedy, a health care reform champion, she seems to take the U.S. Conference of Catholic Bishops actions personally. The influential bishops have emerged as a force in the health care debate, heavilly lobbying lamwakers and sending alerts to followers urging them to support the Senate amendment.
Townsend urges the bishops not to let the single issue of abortion prevent what she sees as a moral imperative of expanding health care to those who need it most.
This isn't the first time she's spoken out on the issue.
Her thoughts echo this LA Times column, which warns health care reform is in jeopardy of being "made hostage to this most divisive of issues." While the Senate defeated the amendment, the House version of the bill includes restrictions on federal funding of abortions. The issue could imperil passage of a health care bill, The Hill reports.
And yet, others -- beyond the bishops and their followers -- argue they simply cannot support reform that does not include restrictions on federal funding for abortions.
So, Picture of Health readers, weigh in on this. What do you make of the tug of war over abortion in health reform? I'm intrigued to know your thoughts on this explosive topic.
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The Centers for Disease Control and Prevention just came out with new swine flu estimates showing the virus has infected some 50 million people in the U.S.
Of that figure, most have been children and young adults, more evidence that the pandemic has spared the elderly.
In addition, the H1N1 virus has caused about 200,000 hospitalizations and nearly 10,000 deaths -- 1,100 of them children.
The estimates are from the start of the U.S. outbreak in the spring through Nov. 14 and update figures the CDC released last month.
The CDC also highlighted an alarming figure in an attempt to drive home how serious the illness can be: Death rates for Native Americans are four times the U.S. average, mostly because of the population's high rates of asthma, diabetes and lack of access to good health care.
The figures come during a lull in swine flu activity -- infections peaked in October, have plunged since and these days, fewer people are clamoring to be vaccinated. Some are even calling the virus the weakest pandemic ever.
So much for infectious disease experts' warnings just a few months ago. Back then, we were told to brace ourselves for as many as half the population sickened, 90,000 deaths, overwhelmed intensive care units and massive absenteeism at schools and workplaces.
Nevertheless, public health officials are using the lull as an opportunity to urge people to get vaccinated in the event that a third wave of the virus takes hold in the cold winter. The flu, as they keep reminding us, is unpredictable.
Johns Hopkins own Carol W. Greider accepts the Nobel Prize for medicine today in Stockholm -- joining just nine other women who have won the honor for medicine and physiology since the awards were first handed out in 1901.
She won for her discovery of an enzyme called telomerase, a substance that plays a crucial role in the genetic life of cells and holds promise for developing treatments to fight cancer and age-related diseases.
Greider has acknowledged that her win is a boon for women in the sciences, where they struggle for parity. On the day of her win, she also alluded to her daily juggle: she was folding laundry when the early-morning call came from the Nobel chairman notifying her of the honor.
Her fellow winner, Elizabeth H. Blackburn outlined the challenges for women trying to balance home and work life in the demanding sciences. Institutions should offer women more flexible schedules. Those 16-hour days in the lab are not compatible with family life, she said in an interview last year.
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Does your child care center serve your kid fatty snacks and sugary drinks? Does your child watch TV more than once a week at day care?
With nearly 25 percent of children ages 2 through 5 classified as obese or overweight, children should learn about healthy lifestyles as early as day care, according to a new report. But for many children, that's not happening, finds the study from Harvard and Duke researchers done for the Robert Wood Johnson Foundation.
Researchers graded states on how well their regulations required children to eat healthy and do physical activity. Most states had just a few regulations on obesity prevention.
Researchers drew up model regulations -- 10 for healthy eating, such as not serving sugar-sweetened drinks, and 10 for physical activity, including providing children 60 minutes a day of exercise. On average, states had just three of the 20 model regulations.
States then were given letter grades on how well they matched the model guidelines. Across the board, the grades were dismal. Maryland was mediocre with a C average. Jeesh.
Georgia and Nevada ranked highest for healthy eating and physical activity regulations, and South Dakota, Puerto Rico, and Idaho ranked lowest. (You can see how states compare here.)
The findings show a need for more stringent state regulations to keep young kids healthy, the authors write. The influence of child care centers is huge. Nearly 75 percent of kids ages 3 to 6 spend their days at day care, according to the report.
"Stronger state regulations aimed at child-care centers have the potential to reduce the risk of obesity for millions of children in the U.S.," said Sara Benjamin, an assistant professor at Duke University. "These providers are in a unique position to encourage very young children to eat healthy foods and be active."
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Good news for men who enjoy a cup -- or more -- of coffee in the morning: avid coffee drinkers may lower their risk of developing prostate cancer, new research suggests.
Now, don't expect doctors to start prescribing morning lattes. The research is preliminary.
But in a federally-funded study of 50,000 men, those who drank the most coffee had a 60 percent less risk of aggressive prostate cancer than non-coffee drinkers, according to data presented at the American Association of Cancer Research conference taking place in Houston.
Well, why is that?
“Coffee has effects on insulin and glucose metabolism as well as sex hormone levels, all of which play a role in prostate cancer. It was plausible that there may be an association between coffee and prostate cancer,” said study author Kathryn M. Wilson, a postdoctoral fellow at the Channing Laboratory, Harvard Medical School in a statement.
Now, "plausible" doesn't mean there's a cause and effect. But the research is interesting, nonetheless. Researchers found for men who drank one to three cups of coffee a day, the risk was lowered by about 20 percent. Those who drank 4 or 5 cups a day, lowered their risk by 25 percent.
Other prostate cancer research finds something not nearly as surprising, but useful all the same. Research out of the conference finds just 15 minutes of exercise a day can reduce overall prostate cancer mortality.
Will you get one?
As infections have declined, it seems interest in the vaccine has too. In recent weeks, county health departments have had trouble filling their clinics. Some people think the worst of the H1N1 pandemic is behind us.
Others say the brace yourselves for a third wave of infections once winter takes hold.
Our Consuming Interests bloggers today are talking about a billing practice that is irking some patients.
Basically, the patients are getting charged fees for visiting their doctor in a clinic setting, verses a private doctor's office. The fees are from the hospitals that run the clinics. Some are also seeing bills for urgent care when they thought they were going in for a routine visit.
It seem as though the patients could just be paying their regular co-pay if they saw their doctor in another office. The bloggers suggest asking when you make your appointment how billing works. They also suggest calling your insurers and challenging the fees.
You can read more about it on Consuming Interests or in the Wall Street Journal via ConsumerWorld.
Anyone have this happen to them?
Baltimore Sun file photo/David Hobby
A group that's been lobbying for health care reform is hoping to get the public in on the action tonight. The Maryland chapter of Health Care for America plans six vigils around the state around 5:30 p.m.
The sites:
• Annapolis at 5:30 p.m.: Sen. Mikulski's District Office, 60 West St.
• Baltimore City at 5:15 p.m.: Washington Monument, 700 N. Charles St.
• Columbia at 5:30 p.m.: Corner of Little Patuxent Pkwy & Sterrett Pl. across from Columbia Mall
• Hagerstown at 5:30 p.m.: Public Square, at the intersection of Potomac & Washington streets
• Hyattsville at 5:30 p.m.: 6700 Belcrest Road
• Silver Spring at 5:30 p.m.: Woodside Park, Spring Street and Georgia Avenue
The group says it wants Congress to pass reform and make health care affordable. It also wants Congress to reform the insurance industry, avoid taxing the middle class and pass a public option -- which the groups says is supported by 70 percent of Americans.
The group also argues that the leading cause of bankruptcy is medical debt.
“We urge Senate Majority Leader Harry Reid, as well as Senators Cardin and Mikulski, to continue to stand with Maryland’s families by doing everything in their power to pass health care reform that provides the choice of a strong national public health insurance option. With 2,547 Americans going bankrupt from medical costs every day, we can’t allow a few senators to derail what the majority of Americans want and need,” said Matthew Weinstein, Maryland coordinator of Health Care for America Now, which is cosponsoring the vigils with MoveOn.org.
The House has passed its version of health care reform, and the Senate is currently debating its measure. If it's passed, the chambers will have to reconcile the bills.
So, if you'd like to join the lobby effort for health care reform -- or even take another position -- here's your chance.
Photo courtesy of MoveOn.org
The Baltimore City Health Department has ordered two city businesses to stop selling children's jewelry found to have levels of lead in excess of what the city allows.
The items include a "Gymnastics bracelet," full of red and blue charms, sold at Beauty Zone, 231 N. Eutaw Street and a "Dora" bracelet and earring set sold at Choice Corner Accessories & Fine Gifts, 400 W. Lexington Street. Both items were found to have lead levels in excess of 600 parts per million, higher than the city limit.
Concerned about lead's damaging effect on children, the city took on the hazard of lead back in 2006, banning its use in jewelry, candy and even eyeliner sold in the city. The effort was spearheaded by Dr. Joshua Sharfstein, former city health department commissioner who now holds the deputy commissioner post at the Food and Drug Administration.
In 2006, the city set a lead level limit of 600 pmm, lower than federal regulations at the time. Earlier this year, the feds lowered its limit to 300 pmm with plans to drop it to 100 pmm in two years. The health department plans to follow suit with new regulations of its own, said a health department spokesman.
The Consumer Product Safety Commission is investigating safety issues of the Zhu Zhu toys, after complaints that they may have unsafe levels of a hazardous metal called antimony.
The probe was sparked by the consumer group Good Guide, says our colleagues at Charm City Moms. The group claims this year's holiday season toy craze contains levels of antimony that could make a child sick, if ingested. The toy maker, Cepia, insists the product is safe.
Could this spell trouble for the insanely popular hamster toys?
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It's among a parent's most dreaded tasks: talking to their teen about sex.
Medical experts and public health advocates say it's not just what you say to teens about sex, but when you say it. Too many parents, it seems, are waiting too long to have "the talk."
More than 40 percent of adolescents have already had sex by the time their parent had talked to them about sexually transmitted diseases and birth control, according to a new study appearing today in the journal Pediatrics.
The findings are based on a survey of 141 parents with children aged 13 to 17. Parents were asked whether they discussed among 24 sex topics -- from body changes during adolescence to how condoms prevent STDs. Researchers followed up with surveys three, six and 12 months later to gauge progress. Meanwhile, participants' children answered separate surveys about their sexual experiences.
While parents did talk to their adolescents about various sexual topics before their first encounter, many parents didn't specifically address birth control options and the proper way to use them, the authors found.
Both parents and clinicians should step up their efforts, the authors suggest, because timing can be critical in helping a child avoid a pregnancy or STD.
The findings don't surprise me as I'm sure many parents of teens shy away from these cringe-worthy conversations for as long as they possibly can. (And teens surely would rather wash the dishes or take out the garbage than talk to mom and dad about sex. Hello awkward!)
But the study's small sample size is certainly a limitation. And I wonder if more parents are discussing these issues with their teens these days in the era of Gardasil commercials and the increasing attention the drug has brought to cervical cancer.
Are you the parent of a teen? Have you had the dreaded talk?
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We've told you before to be on the lookout for fake swine flu cures being hawked on the internet. Well, there's a new swine flu scam out there on the web.
The CDC has established no such thing. The phishing emails, which ask people to create a personal profile on the CDC website so they can get vaccinated, could cause your computer some serious trouble, the agency warns.
"Users that click on the email are at risk of having malicious code installed on their system," according to the CDC announcement.
Just another reminder to be careful entering personal information online and be on the lookout for strange-looking email from sites you haven't heard of. My motto: If I don't know the sender, I don't open the message. (With the exception being reader emails.)
P.S. If you're still on the hunt for an H1N1 vaccine and you're local, visit our Swine Flu site for information with links to local health department clinics.
AP photo
Diabetes is deadly and costly. And the number of people with the disease and the cost to treat them is only expected to soar in the coming years, according to a new study.
In the next 25 years, the number of Americans with diabetes is expected to double from nearly 24 million in 2009 to 44 million in 2034 and the cost of treating the disease will triple from $113 billion to $336 billion, says a new report in the journal Diabetes Care.
The rise in diabetes cases will take a huge toll on the already strained Medicare system. Medicare spending on diabetes is expected to rise from $45 billion to $171 billion, the report estimated.
"If we don't change our diet and exercise habits or find new, more effective and less expensive ways to prevent and treat diabetes, we will find ourselves in a lot of trouble as a population," said the study's lead author Dr. Elbert Huang, an assistant professor of medicine at the University of Chicago.
Much of the increase will be driven by aging baby boomers, who are nearing the age where they are at higher risk for developing the disease. While not all types of diabetes are preventable, type 2 diabetes -- which accounts for 90-95 percent of all cases -- is linked to obesity.
Still -- and this is fascinating - researchers expect the number of diabetes cases to soar, even if obesity rates remain don't increase.
The figures mirror projections published elsewhere and hope to sound the alarm on the huge impact of the disease. The CDC estimates that if current trends continue, 1 in 3 Americans will develop diabetes over their lifetime.
Not only is diabetes dangerous -- it's the sixth leading cause of death in the nation -- it is costly. The journal Health Affairs highlights the huge expense: Chronic diseases in general account for three-quarters of health care spending and nine chronic diseases -- diabetes included -- account for the 60 percent rise in Medicare costs.
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For millions of laid off workers, COBRA, the federal program that allows workers to keep their health benefits, has been a lifeline.
But this week, the government ended crucial subsidies that allow many workers to afford the steep price of keeping their insurance.
That result: hundreds of thousands of workers who relied on those subsidies will be forced to pay premiums as high as three times what they are paying now.
People who began receiving the subsidies in March, when they started, lost the benefit on Monday. The subsidies last nine months.
Consumer advocacy group Families USA warns that will cause many to join the already crowded ranks of the uninsured. In Maryland, average premiums could rise from $397 a month with the subsidy, to $1,133 without the government help, according to the new study from Families USA, which outlines costs for each state and urges congress to extend the subsidies.
Some Democrats in Congress are pushing to extend the subsidies for laid off workers, according to this McClatchy story.
There's no question the subsidies have been vital to people who have been laid off. From February -- the month before the government started the subsidy -- through August, COBRA enrollment doubled, according to an analysis by Hewitt and Associates, a human relations consulting firm.
Hospital infections can be deadly. In fact, preventable infections are among the top 10 causes of death in the U.S., according to the CDC.
And while much attention has been given to the topic of late, infection rates are still high worldwide, according to new research published in the Journal of the American Medical Association.
In a study of 14,000 patients in intensive care units in 75 countries, half had infections, the study found. The more time patients spent in the ICU, the more likely they were to get an infection. And patients with infections were more likely to die than those without.
Specifically, patients who stayed in the ICU for up to a day had an infection rate of 32 percent. That figure jumped to 70 percent for patients with an ICU stay of more than a week, the team of international researchers found. Wow. Infected patients had twice the mortality rate than those not infected -- 25 percent vs. 11 percent.
The issue is serious. Consider that infections are the leading cause of death in non-cardiac ICUs -- mortality rate is 60 percent and such complications account for 40 percent of ICU spending.
Gains have been made in this country on the issue -- here's one recent story out of Boston. And closer to home, Johns Hopkins safety guru Dr. Peter Pronovost developed an award-winning five step program to combat them.
And yet, serious problems remain, the authors write.
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On this World AIDS Day public health officials are reminding everyone that while tremendous progress has been made, the fight against HIV/AIDS is far from over.
More people are getting life-saving treatment for the disease and new AIDS infections are down 17 percent over the last eight years, according to UNAIDS.
Nevertheless, there is still no vaccine and the epidemic continues to rage across the globe. Even here in the states, more than 1 million people are infected by the virus and 1 in 5 of them don't know it, according to the CDC. In Maryland, an estimated 6,000 to 9,000 people have HIV and aren't aware of it, according to the state health department.
And so, the mantra among health officials: Get tested.
Locally, health departments across the state are offering free testing and other events to mark the occasion. In Baltimore, a city that has been hit hard by AIDS, a candlelight vigil is planned for 7 p.m. at the Mount Vernon Place United Methodist Church. For more information and for testing sites see the health department website: www.baltimorehealth.org/worldaidsday. Anne Arundel County is offering free testing from noon to 6 p.m. at First Presbyterian Church in Annapolis. For more information on other events, visit the state health department site for details.
Said Maryland Health Secretary John M. Colmers: “By working together we can ensure that everyone knows their HIV status and routinely tests for HIV. Knowledge is power.”
In addition, researchers and public health advocates are hoping to draw attention to the latest findings on the costs and challenges of fighting HIV/AIDS. The journal Health Affairs has devoted much of its December issue to the topic.
The World AIDS Day site offers statistics, event details and personal stories.
We've been urged for years to cook poultry thoroughly to prevent food-borne illness. But just how contaminated are store-bought chickens in the first place?
Consumer Reports' latest test finds two-thirds of whole broilers bought in grocery stores nationwide tested positive for salmonella and or campylobacter, the leading bacterial causes of food-borne disease.
The magazine has been testing chickens since 1998. The new findings are a slight improvement from last year's. But advocates at Consumer Reports say the contamination is still too high and it is evidence that tighter government regulations are needed to ensure safe poultry.
Each year, some 3.4 million Americans are infected with salmonella and campylobacter. Another 25,500 are hospitalized and 500 die, according to the report which sites CDC estimates.
The report found campylobacter in 62 percent of chickens and salmonella in 14 percent. Of the big brands, Perdue had the best score; Tyson, the worst. Air-chilled broilers were the cleanest chickens with about 60 percent showing no trace of either bacterium. Organic chickens showed no salmonella at all, but less than half --43 percent -- were free from campylobacter.
The best away to avoid contamination: cook chicken to at least 165 degrees and be careful with your prep. Be sure to keep chicken from touching other foods. Here's Consumer Reports' full list of precautions.
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Meredith Cohn has been a reporter since 1991, covering everything from politics and airlines to the environment and medicine. A runner since junior high and a particular eater for almost as long, she tries to keep up on health and fitness trends. Her aim is to bring you the latest news and information from the local and national medical and wellness communities. 
Andrea K. Walker knows it’s weird to some people, but she has a fascination with fitness, diseases, medicine and other health-related topics. She subscribes to a variety of health and fitness magazines and becomes easily engrossed in the latest research in health and science. An exercise fanatic, she’s probably tried just about every fitness activity there is. Her favorites are running, yoga and kickboxing. So it is probably fitting that she has been assigned to cover the business of healthcare and to become a regular contributor to this blog. Andrea has been at The Sun for nearly 10 years, covering manufacturing, retail , airlines and small and minority business. She looks forward to telling readers about the latest health news.
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The swine flu vaccine is now available to anyone who wants one, Maryland officials announced yesterday
