4 in US now linked to German E. coli outbreak (AP)

ATLANTA � Four people in the U.S. were apparently sickened by the food poisoning outbreak in Europe, health officials said Friday. Three are hospitalized with a serious complication.

All four were in northern Germany in May. Though they didn't stay at the same hotel or eat at the same restaurants, officials are confident that they were infected with E. coli in that country.

Three of them � two women and a man � are hospitalized with kidney failure, a complication of E. coli that has become a hallmark of the outbreak. One of the four fell ill while on a plane to the U.S.

Two other cases are being investigated in U.S. service members in Germany, said Dr. Chris Braden, of the Centers for Disease Control and Prevention.

The source of the outbreak hasn't been pinpointed but the focus has been on fresh tomatoes, lettuce and cucumbers. More than 1,800 people have fallen ill, nearly all in Germany.

In a teleconference Friday with reporters, a Food and Drug Administration official said produce in the U.S. remains safe. The government has stepped up testing of food from Germany and Spain, but very little is imported from those countries or the rest of Europe.

The United States has "one of the safest food supplies in the world," said Don Kraemer, deputy director of the FDA's Center for Food Safety and Applied Nutrition.

Few details about the four ill people in the U.S. have been released. It's not known if they are U.S. residents or visitors. Milwaukee Health Commissioner Bevan Baker said Friday that one of the four � an adult who traveled from Germany � was in an area hospital.

Health officials have been reluctant to discuss the cases because of patient confidentiality. "We don't want there to be an overreaction, or people to feel stigmatized because they just happened to get back from Germany," said Dr. Robert Tauxe, a CDC foodborne disease expert.

The risk of the four cases triggering outbreaks in the U.S. is considered very small, he added.

"We don't think it spreads from one person to another rapidly" and will not move through the population like the flu, he said.

The CDC sent a notice to U.S. doctors Friday, advising them to be on the alert for cases.

As the investigation into the E. coli strain from the outbreak continues, CDC officials say they have never seen the strain here but are aware of at least two previous reports of a similar strain elsewhere. One was a 29-year-old woman in South Korea, reported in 2006. The other was a small cluster of cases in the Republic of Georgia in 2009.

___

Online:

CDC: http://www.cdc.gov/ecoli

.

Powered By WizardRSS.com | Full Text RSS Feed | Amazon Plugin | Settlement Statement | WordPress Tutorials

Germany: E. coli patients continue to rise (AP)

BERLIN � The number of people sickened by a mysterious strain of E. coli in Europe is still rising more than a month after it was first detected, but officials say there are now signs the bacterial outbreak responsible for at least 18 deaths could be slowing.

Since the first case of a patient in Germany detected with the bacteria on May 1, the country's national disease control center reported Friday that there are now 1,733 people in the country who have been sickened, including 520 suffering from a life-threatening complication that can cause kidney failure.

The World Health Organization said that 10 other European nations and the U.S. have reported a total of 90 people sick from the bacteria, all but two of whom had recently visited northern Germany or, in one case, had contact with a visitor from the region.

Though nearly 200 new cases of E. coli infection were reported in Germany in the first two days of June, the Robert Koch Institute disease control center said new infections peaked on May 21 and May 22, and have since then been dropping.

Though it cautioned that what appears to be a downward trend could change if there are new cases that have not yet been reported, there are other signs that the outbreak could be waning.

Kidney specialist Dr. Reinhard Brunkhorst, the president of the German Nephrology Society, told reporters in Hamburg that hospitals are now seeing fewer new infections reported each day, though cautioned that "it may be less, but it's not over yet."

"There is no reason for hysteria, because it's not spreading and it's not increasing � it's decreasing," he said.

While suspicion has fallen on raw tomatoes, cucumbers and lettuce as the source of the germ, researchers have been unable to pinpoint the food responsible.

The outbreak is considered the third-largest involving E. coli in recent world history, and it is already the deadliest. Twelve people died in a 1996 Japanese outbreak that reportedly sickened more than 9,000, and seven died in a Canadian outbreak in 2000.

Researcher Dag Harmsen at the Muenster University Hospital, which has been closely involved in the investigation of the outbreak, said that scientists were hoping to know enough about the E. coli strain by next week to be able to prevent new infections and better treat patients.

The WHO recommends that to avoid food-borne illnesses, people wash their hands, keep raw meat separate from other foods, thoroughly cook their food, and wash fruits and vegetables, especially if eaten raw. Experts also recommend peeling raw fruits and vegetables if possible.

As the number of consumers avoiding vegetables grows, European farmers say they are losing millions of euros every day.

Russia on Thursday extended a ban on vegetables from Spain and Germany to the entire European Union to try to stop the outbreak spreading east, a move the EU quickly called disproportionate and Italy's farmers denounced as "absurd." No deaths or infections have been reported in Russia.

Russian Prime Minister Vladimir Putin on Friday rejected the EU claim, saying that authorities in Russia can't risk population's health by allowing EU vegetable imports at a time when the authorities in countries affected have failed to determine the cause of the outbreak.

Meanwhile, Chancellor Angela Merkel agreed with Spanish Prime Minister Jose Luis Rodriguez Zapatero in a telephone conversation late Thursday to push for EU help for affected farmers, Merkel's spokesman said.

Merkel, however, also defended the decision of state officials in Hamburg to announce their suspicions that Spanish cucumbers were the possible source of the outbreak. The warning was given after three cucumbers from Spain tested positive for E. coli, but further tests then revealed that it was a different strain to the one that has sickened so many people in the northern port city and elsewhere.

"The chancellor indicated great understanding for the urgent economic situation in the Spanish produce sector," spokesman Steffen Seibert said.

"At the same time she noted the responsibility of the German agencies to keep citizens informed in all phases and to report test results to the European early warning system."

In the southern Spanish tourist resort town of Torremolinos, Spaniards handed out about 7 tons of cucumbers free to the public in a show of support for the farmers affected by the outbreak who have seen their market collapse.

___

Ciaran Giles in Madrid and Kirsten Grieshaber in Berlin contributed to this story.

Powered By WizardRSS.com | Full Text RSS Feed | Amazon Plugin | Settlement Statement | WordPress Tutorials

30 years after first AIDS cases, hope for a cure (AP)

Sunday marks 30 years since the first AIDS cases were reported in the United States. And this anniversary brings fresh hope for something many had come to think was impossible: finding a cure.

The example is Timothy Ray Brown of San Francisco, the first person in the world apparently cured of AIDS. His treatment isn't practical for wide use, but there are encouraging signs that other approaches might someday lead to a cure, or at least allow some people to control HIV without needing medication every day.

"I want to pull out all the stops to go for it," though cure is still a very difficult goal, said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.

For now, the focus remains on preventing new infections. With recent progress on novel ways to do that and a partially effective vaccine, "we're starting to get the feel that we can really get our arms around this pandemic," Fauci said.

More than 25 million people have died of AIDS since the first five cases were recognized in Los Angeles in 1981.

More than 33 million people have HIV now, including more than 1 million in the United States.

About 2 million people die of the disease each year, mostly in poor countries that lack treatment. In the U.S. though, newly diagnosed patients have a life expectancy only a few months shorter than people without HIV. Modern drugs are much easier to take, and many patients get by on a single pill a day.

But it wasn't that way in 1995, when Brown, an American working as a translator in Berlin, learned he had HIV. He went on and off medicines because of side effects but was holding his own until 2006, when he was diagnosed with leukemia, a problem unrelated to HIV. Chemotherapy left him so sick he had to be put into a coma to allow his body to recover.

"They didn't know if I'd survive that," Brown said.

Dr. Gero Huetter, a blood cancer expert at the University of Berlin, knew that a transplant of blood stem cells (doctors used to use bone marrow) was the best hope for curing Brown's cancer. But he aimed even higher.

"I remembered something I had read in a 1996 report from a study of people who were exposed to HIV but didn't get infected," Huetter said.

These people had gene mutations that provide natural resistance to the virus. About 1 percent of whites have them, and Huetter proposed searching for a person who also was a tissue match for Brown.

But transplants are grueling. Huetter would have to destroy Brown's diseased immune system with chemo and radiation, then transplant the donor's cells and hope they would take hold and grow. Many cancer patients die from such attempts and Brown wasn't willing to risk it.

His mother, Sharon Brown of Seattle, agreed.

"Before I knew he had HIV I used to have nightmares about it," and gambling on a transplant to try to cure it didn't seem smart when the cancer seemed to be in remission, she said.

Several months later, the return of leukemia changed their minds.

Brown discussed the transplant with his boss "and she said, `wow, this is amazing. Because you have leukemia, you could be cured of HIV.'"

A registry turned up more than 200 possible donors and Huetter started testing them for the HIV resistance gene. He hit pay dirt at No. 61 � a German man living in the United States, around 25 years old.

Brown had the transplant in February 2007. A year later, his leukemia returned but HIV did not. He had a second transplant in March 2008 from the same donor.

Now 45, Brown needs no medicines, and his only health problems are from the mugging he suffered two years ago as he returned home one night in Berlin. Brown was knocked unconscious, required brain surgery and therapy to walk and talk again, and doesn't have full use of one arm. He moved back to the United States in December.

"He's now four years off his antiretroviral therapy and we have no evidence of HIV in any tissue or blood that we have tested," even places where the virus can lie dormant for many years, Huetter said.

Brown's success inspired scientists to try a similar but less harsh tactic: modifying some of a patient's infection-fighting blood cells to contain the mutation and resist HIV. In theory, this would strengthen the immune system enough that people would no longer need to take HIV drugs to keep the virus suppressed.

Scientists recently tried this gene therapy in a couple dozen patients, including Matthew Sharp of suburban San Francisco. More than six months later, the number of his infection-fighting blood cells is "still significantly higher than baseline," he said.

It will take more time to know if gene therapy works and is safe. Experiments on dozens of patients are under way, including some where patients go off their HIV medicines and doctors watch to see if the modified cells control the virus.

The results so far on the cell counts "are all wonderful findings but they could all amount to nothing" unless HIV stays suppressed, said Dr. Jacob Lalezari, director of Quest Clinical Research in San Francisco who is leading one of the studies.

The approach also is not practical for poor countries.

"I wouldn't want people to think that gene therapy is going to be something you can do on 33 million people," said Fauci.

Other promising approaches to a cure try new ways to attack the dormant virus problem, he said. They hinge on getting people tested and into care as soon as they become infected.

Fauci's institute has boosted money for cure research, and the International AIDS Society, a professional organization for those who work in the field, has added finding a cure to its strategic plan.

"There are paths forward now" to a day when people with AIDS might be cured, said Dr. Michael Horberg, president of President Obama's HIV/AIDS council and of the HIV Medicine Association, doctors who treat the disease. "But it's not tomorrow, and it's not today."

___

Online:

AIDS information: http://www.aidsinfo.nih.gov

and http://www3.niaid.nih.gov/topics/HIVAIDS/

___

Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP

Powered By WizardRSS.com | Full Text RSS Feed | Amazon Plugin | Settlement Statement | WordPress Tutorials

App for mobile phones helps diagnose concussions (AP)

CHAPEL HILL, N.C. � The next tool in the campaign against concussions might be your smartphone.

A doctor at the University of North Carolina teamed with other head-trauma researchers to develop an application for mobile devices that helps determine whether someone may have suffered a concussion.

Jason Mihalik of UNC's brain injury research center joined Justin Smith of Psychological Assessment Resources Inc. and the Children's National Medical Center in developing the program.

Smith says it's the first observer-based concussion app. After the user answers a series of questions, the app determines the likelihood of a concussion and can email information to a doctor. Mihalik said Thursday that the basis for the app's question flow comes from materials provided by the Centers for Disease Control.

The introduction of the app is just one way to speed the response to possible concussions. One of the key issues discussed during the National Sports Concussion Cooperative's daylong seminar was how to most effectively bridge the communication gap between team doctors and the team athletic trainers, who often are the first to act when players suffer concussion-like symptoms.

"The documentation (of immediate symptoms) is very important, from, 'How did they get hurt?' to the mechanism of injury through those initial signs and symptoms, to 'How did they progress over time?'" said Bill Griffin of the National Athletic Trainers' Association. "It's not only what happens at the time of the injury, but how things change."

The cooperative consists of coaches, doctors, equipment manufacturers and parents, and the group was formed in March to study concussions and brain trauma injuries in an attempt to make sports safer.

"We're trying to do more. We think there is an opportunity to do more," said Art Chou, Rawlings' vice president of research and development. "The caution that we have as manufacturers is, are we ready to draw definitive conclusions? ... There's a balance there, and I think it's up to the research community to determine whether it is ready for prime time or not, because the issue is going to be one of public perception.

"The issue is, have we confused the public? ... I would like to see more consensus from the research community that supports that, because we need more data. We need to move the needle. ... The last thing we need, I think now, as a whole football community, is going back and forth and confusing the issue any more."

Mike Oliver, the executive director of the National Operating Committee on Standards for Athletic Equipment, continued to express a longstanding desire to come up with a safety standard for youth helmets.

But he cautioned that it's dangerous to rush to a conclusion before the scientific research is complete. NOCSEA, a nonprofit corporation, formed in 1969 in response to a need for a performance test standard for helmets.

"You want to have an answer. You want to have a solution to the problem," Oliver said. "You want to be able to say ... 'We do have a solution to the problem and you can have a level of confidence (that) you will have a level of protection. ... But we can't do that until we have the science behind it."

Powered By WizardRSS.com | Full Text RSS Feed | Amazon Plugin | Settlement Statement | WordPress Tutorials

E. coli outbreak points to gaps in US food system (AP)

WASHINGTON � The nasty form of E. coli hitting Europe points out gaps in the U.S. food safety system that raise concern that similar outbreaks might happen here.

It's impossible to test for every illness-causing form of E. coli, even the kinds we already know about.

Today, the food industry and health authorities focus mostly on a single strain of the bacteria that until now was considered the most dangerous. But some different strains collectively known as "the other E. colis" were sickening more and more people well before this extra-deadly European bug burst on the scene.

"It's a wake-up call around the world," said Dr. Robert Tauxe of the Centers for Disease Control and Prevention, which has long been concerned about the lesser known strains.

Authorities don't yet know the source of the European infection, but cucumbers, tomatoes and leafy lettuce grown there are suspected.

There's no reason to stop eating fresh vegetables in the United States, but officials are monitoring the situation carefully. The Food and Drug Administration has stepped up testing of those foods imported from affected countries as a precaution, although very little is imported.

And Agriculture Secretary Tom Vilsack said Thursday there's no immediate threat from what's happening in Europe. "We have to constantly look for ways to improve food safety, and that requires us to make sure that we're testing for the right things," he said.

USDA, under pressure from consumer groups, already was working on a measure to address some of the other E. colis in beef, a policy being reviewed by the Obama administration. Researchers created tests to screen for the six strains considered most prevalent, before the toll in Europe revealed a seventh.

When it comes to fresh produce, a sweeping new law requires the FDA to set standards to guard against contamination of all sorts. The rules are expected to address such things as properly processed compost, worker hygiene, and keeping animals and their runoff from fields or irrigation water.

It's not clear how quickly those rules will emerge; Republican-led efforts to cut FDA's budget would strain the work.

"There are no regulations in place today that would prevent this kind of outbreak from occurring" in the U.S., said food-safety expert Caroline Smith DeWaal of the Center for Science in the Public Interest.

But specialists say the broad focus promised by the food-safety law is critical to get ahead of the next emerging germ, rather than racing to develop tests for each new strain.

"You never know what's around the corner that's just waiting to bite you," said former FDA assistant commissioner Dr. David Acheson, now a food-safety consultant. "You cannot test your way to safety, you just can't do it."

The produce industry says it's not waiting on the FDA. Some growers in California and other areas, for example, have voluntarily adopted such standards as not harvesting leafy greens within 5 feet of feces or other animal activity in a field, said David Gombas of United Fresh Produce. What prevents the long-targeted E. coli strain should prevent these newly worrisome varieties, too, he said.

E. coli is incredibly common. Hundreds of strains, most of them harmless, live in the intestines of humans, cows and numerous other animals. But some produce toxins that can cause diarrhea, sometimes severe enough to trigger kidney failure, even death.

The most dangerous form in the U.S. has been the E. coli O157:H7 strain, notorious since a 1993 outbreak at a fast-food chain led to its classification as an adulterant in meat, requiring testing and recalls. A 2006 outbreak in spinach highlighted the threat to fresh produce, too. The CDC estimates that strain alone causes about 63,000 foodborne illnesses a year.

In Europe's unusually large outbreak, an emerging super-strain named O104:H4 has sickened at least 1,600 people and killed 18. Most surprising is that nearly 500 of those victims have that kidney damage, more than typical with other strains.

It's not clear why this particular strain is so virulent. But genetic testing suggests a toxin-spewing form of the bug combined with another strain that attaches to a patient's gut in a more aggressive way � the germs stacking in a brick-like pattern rather than individually, said Acheson. He has long studied E. coli and warned years ago that lesser known strains were "just accidents waiting to happen."

In fact, CDC's Tauxe says that other toxin-forming E. colis altogether cause more illnesses � about 112,000 U.S. cases a year � than the most targeted type. But the other E. colis got less attention because they tended to cause smaller outbreaks, like the one in romaine lettuce blamed for two dozen illnesses in five states last year.

That's why Bill Marler, a Seattle attorney who specializes in food poisoning cases, petitioned USDA to mandate beef testing for the other E. colis, knowing that other foods tend to follow the meat industry.

"If E. coli O157 is an adulterant in hamburger, then these other bugs should be, period," he said.

Tauxe cautions there's a lot to learn about these other E. colis. Later this year, the CDC will begin a study to identify risk factors, what foods and which people seem particularly vulnerable.

___

Associated Press writer Mary Clare Jalonick contributed to this report.

Powered By WizardRSS.com | Full Text RSS Feed | Amazon Plugin | Settlement Statement | WordPress Tutorials

Food pyramid out, 'My Plate' in for healthy eating (AP)

WASHINGTON � There's a new U.S. symbol for healthful eating: The Agriculture Department unveiled "My Plate" on Thursday, abandoning the food pyramid that had guided many Americans but merely confused others.

The new guide is divided into four slightly different-sized quadrants, with fruits and vegetables taking up half the space and grains and protein making up the other half. The vegetables and grains portions are the largest of the four.

Gone are the old pyramid's references to sugars, fats or oils. What was once a category called "meat and beans" is now simply "proteins," making way for seafood and vegetarian options like tofu. Next to the plate is a blue circle for dairy, which could be a glass of milk or a food such as cheese or yogurt.

Some critics, including congressional Republicans, have charged the Obama administration of reaching too far in trying to make Americans eat healthier, especially when it comes to new rules that tell schools what children can eat on campus.

The new plate is simply guidance for those looking to improve their diet, however. It's supposed to be a suggestion, not a direction, said Agriculture Secretary Tom Vilsack.

"We are not telling people what to eat, we are giving them a guide," he said. "We're not suggesting they should not have a cookie or dessert, that's not what it's about."

Vilsack said the new round chart shows that nutrition doesn't have to be complicated. After almost 20 years of leaders preaching good eating through a food pyramid the department now says was overly complex, obesity rates have skyrocketed. He showed off the new plate with first lady Michelle Obama, who has made healthful diets for children a priority through her "Let's Move" campaign.

"Parents don't have the time to measure out exactly three ounces of protein," Mrs. Obama said as she introduced the new graphic. "We do have time to look at our kids' plates."

The department is planning to use social media � posting advice every day on Twitter, for example. The address of the accompanying website, choosemyplate.gov, is written on the chart. That website will eventually feature interactive tools that help people manage their weight and track their exercise.

The new chart is designed to be "more artistic and attractive" and to serve as a visual cue for diners, said Robert Post of the Agriculture Department's Center for Nutrition Policy and Promotion. He has spent two years developing the plate and the website.

Even though the plate is divided into four different-sized sections, the servings don't have to be proportional, Post says. Every person has different nutritional needs, based on age, health and other factors.

The graphic is based on new department dietary guidelines released in January. Those guidelines, which are revised every five years, tell people to drastically reduce salt and continue limiting saturated fats. They say diners can enjoy food but should balance calories by eating less. The guidelines also suggest making half of your plate fruits and vegetables � a message easily translated on the dinner plate.

"We know Americans want to be healthy, but making those healthy choices is not easy, it's hard," said Surgeon General Regina Benjamin, who joined Mrs. Obama and Vilsack to unveil the plate. "We're trying to make it easier."

The guidelines and the icon were subject of lobbying by food industries who want to see their products promoted and not discouraged. Fruit and vegetable growers were celebrating their victory over half of the plate Thursday, while dairy producers said they were also pleased with the cup beside it. The president of the beef industry group National Cattleman's Beef Associaton, Bill Donald, said he is not concerned about the elimination of the word "meat" because beef is so associated with the word "protein."

The first food pyramid was introduced in 1992, with detailed descriptions of recommended foods and their portion sizes. The tip of the pyramid represented fats, oils and sweets, cautioning diners to "use sparingly."

After research showed the pyramid wasn't working, the department worked with a public relations firm and came up with an all-new pyramid in 2005 that was characterized by vertical lines of color and a stick figure walking up a staircase to symbolize exercise. At the time, officials said they wanted something motivational and recognizable. But the Obama administration eventually ditched that model, opting for something fresher.

Many nutritionists and nutrition groups praised the newest effort, crossing their fingers that people will listen.

Marion Nestle, professor of nutrition, food studies, and public health at New York University, said there are already a lot of symbols out there telling people what to eat. She said the new model isn't perfect, it's a good step forward.

"This brings it all together," she said. ___

Online:

USDA website: http://www.usda.gov

Powered By WizardRSS.com | Full Text RSS Feed | Amazon Plugin | Settlement Statement | WordPress Tutorials