CDC: Chickenpox deaths plummeted since vaccine (AP)

ATLANTA � Chickenpox vaccine has dramatically cut deaths from the disease, especially in children, says a new government study proclaiming an important public health victory.

Researchers from the Centers for Disease Control and Prevention found that chickenpox deaths fell from an average of 105 per year to 14 after the vaccine had been available for a dozen years.

Deaths declined in all age groups, but the drop was most significant among children.

"To see the near elimination of chickenpox deaths in this country is very exciting," said Jane Seward, a CDC official who co-authored the paper. She has been involved in the agency's chickenpox vaccine program for 15 years.

The report was released online Monday by the journal Pediatrics.

Chickenpox is caused by a virus and is highly contagious. Symptoms include an itchy skin rash and fever. Most kids suffer no more than that, but some suffer complications like skin infections, swelling of the brain and pneumonia. Severe cases are more common among adolescents and adults who get it for the first time. Also, the virus � called varicella � can reactivate in people later in life and cause a painful illness called shingles.

While rarely fatal, chickenpox was very common before the vaccine � nearly one in 10 pre-adolescent children would get it in a year, said Dr. Eugene Shapiro, a Yale University expert in infectious disease.

In 1995, the government first recommended that all children get a dose of chickenpox vaccine. One dose turned out to be about 86 percent effective. A second dose is now recommended.

The new CDC study looked at national records for deaths attributed to chickenpox. In the five years before the vaccine, an average of 105 Americans died of the virus annually. By 2007 � 12 years after the vaccine � the annual death toll had dropped to 14, and almost all were adults.

The vaccine deserves credit for the decline in children's deaths, Seward said. It's also likely cut adult deaths because there are fewer infected children around to spread it to adults, she added.

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Online:

CDC: http://tinyurl.com/chickenpoxinfo

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'30 days of hell' for US victim of German E. coli (AP)

ATLANTA � In early May, John Meyer stayed at a lakeside hotel in Hamburg, Germany. He attended a business conference. He went sailing. And he became one of the few U.S. victims in one of the worst food poisoning outbreaks in recent world history.

Meyer went to the hospital a week later with what turned out to be a rare and deadly strain of E. coli bacteria that caused thousands of illnesses, mostly in Germany. He would spend the next month in a Massachusetts hospital, much of the time a delirium, while doctors worked around the clock to save his life.

Meyer is one of six U.S. cases linked to the German outbreak and he's the first to talk about his terrible experience, speaking to The Associated Press by phone from his home in Franklin, Mass.

"It was 30 days of hell," said his wife, Loreen.

Meyer was in Hamburg as that city was emerging as the epicenter of a food poisoning disaster that would be among the deadliest in memory. More than 4,000 people in Germany and other countries became ill since the outbreak was detected in May, including several hundred who developed a serious complication that can lead to kidney failure. At least 53 died.

The outbreak ultimately was traced to a batch of fenugreek seeds from Egypt. The seeds, which taste a bit like burnt sugar, are sometimes used as a spice in cooking. Fenugreek sprouts are used in salads.

Meyer believes he must have eaten fenugreek while attending a business meeting at the Hamburg hotel. He thinks the tainted seeds, or sprouts, could have been in the fresh fruits and vegetables at a breakfast bar. There would be some irony if that was the case: It's hard to find good produce during hurried business trips, and Meyer had welcomed the opportunity to eat healthy.

"In this case, it backfired," he said.

Meyer's lawyer provided the AP with lab results and government investigation reports into his illness. Massachusetts state health officials also confirmed he was infected with the rare German E. coli strain. Meyer declined to allow his doctor to speak to the AP and he would not agree to be photographed.

Some common forms of food poisoning can cause symptoms within a day of eating tainted food, but Meyer said he felt no ill effects during a six-day European business trip that included two days in Hamburg and a brief stop in France afterward. He returned home on May 13 feeling fine.

However, this unique and dangerous E. coli bug takes a week to announce its presence. Meyer first became aware something was wrong on May 18. He was at his desk at Senior Aerospace that morning when his abdomen began hurting.

At 52, he is a cyclist who eats two Greek yogurts each day. He says he's never had food poisoning, but on that day he went home in pain.

By midafternoon, he was hit with bloody diarrhea and a dawning sense of alarm. "Whatever it was, it wasn't a minor thing," Meyer said. His wife Loreen, a high school biology teacher, was home by then and worried. She took him to nearby Milford Regional Medical Center.

Doctors there saw him quickly but weren't able to diagnose him. They recommended follow-up with a gastroenterologist the next day and sent him home for the night. But when he got home the diarrhea accelerated. "Every hour, and then it started getting even closer," he recalled.

Loreen took him back to the hospital that night and he was admitted.

Though it all happened less than two months ago, Meyer's memory is fuzzy on what happened the next several weeks. He had intense stomach pain and his kidneys stopped working. Doctors put him on fluids to rehydrate him. They treated him with different antibiotics, and cleansed his blood using dialysis and other measures.

The infection affected his mind. He recalled staring at a clock in his hospital room and not being able to tell time. "I was thinking, `Why do they have this strange clock in here, and why is it set up differently?'"

Meyer said he grew paranoid, believing that his doctors had written him off for dead. Doctors had not given up on him, but were perplexed. A test for the most dangerous form of E. coli familiar to Americans came back negative. They sent specimens for additional analysis to lab with the Centers for Disease Control and Prevention lab in Atlanta.

In early June, CDC confirmed it was the German strain.

Around that time, he had begun to recover. His kidneys were improving. His awareness returned. He was moved out of intensive care more than three weeks later, and on June 17 he was sent home.

But he was far from normal. He and his wife said his muscles had atrophied, his red blood cell count was still down, and the lining of his colon had become a layer of dead tissue, unable to absorb nutrients. A man who had been an athletic 6-foot 2 and 185 pounds was down to 162 pounds and able to walk only short distances using a cane. He was hungry, though. Voracious, even, eating two breakfasts, two lunches and two dinners each day.

"He had such a huge appetite because he was still not able to absorb as many nutrients," his wife said.

Now he's up to 170 pounds and working part days from home. He's been in physical therapy and regaining his strength, though he's months away from the kind of vigorous exercise he used to do.

Meyer and his wife contacted a local attorney, saying they were worried about possible problems with getting health insurance to pay his hospital bills. That turned out not to be an issue. But the attorney referred the couple to Bill Marler, a Seattle lawyer considered the nation's pre-eminent plaintiff's attorney in food poisoning cases.

Marler is looking into the possibility of a lawsuit, with potential targets including the company that owns the Hamburg hotel where Meyer stayed.

He called Meyer's suffering "horrific," and echoed Meyer's wife in worrying that he may suffer long-term problems.

For his part, Meyer feels lucky to have survived, crediting his doctors for saving his life and his good health and fitness before the illness for helping him get through it.

"Many unfortunate people didn't survive," he said. "It really is a frightening thing."

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Govt proposes clearer labeling of meat additives (AP)

WASHINGTON � The Agriculture Department wants consumers to know when there's less chicken in their chicken.

A proposed rule aimed at food companies would require that poultry and other raw meats be labeled appropriately when they're plumped up by added solutions such as chicken broth, teriyaki sauce, salt or water. The practice of adding those ingredients is common, but many consumers don't know about it.

According to USDA, about one-third of poultry, 10 percent of beef and 90 percent of pork may have added ingredients � about 40 percent of all raw, whole cuts of meat. The rule does not apply to ground beef, which may have other added substances.

"Consumers should be able to make an informed choice in the store, which is why we need to provide clear, informative labels that will help consumers make the best decisions about feeding their families," said Elisabeth Hagen, head of food safety at the department. "It has become evident that some raw meat and poultry labels, even those that follow our current guidelines, may not be clear."

Labels now say that the meat contains added solutions or is "enhanced," but they may not be visible to consumers or understandable. If the rules are finalized, the label would now have to be part of the product title. An example of the new labels would be "chicken breast � 40% added solution of water and teriyaki sauce," according to USDA.

Richard Lobb of the National Chicken Council says the poultry industry is split on the issue, as some companies add ingredients to their poultry and some don't. He said the level of added ingredients in poultry is generally 15 to 18 percent of the piece of meat.

Red meat processors immediately objected to the rule. The American Meat Institute called it "wasteful" and "unnecessary" and said it would cause prices to go up for consumers.

Consumer groups have been pressuring the department to crack down on the practice for several years, saying the added ingredients are unhealthy.

"Who wants to pay $4.99 a pound for the added water and salt?" said Michael Jacobson, executive director of the advocacy group Center for Science in the Public Interest. "Besides cheating customers financially, `enhancing' meat and poultry delivers a stealth hit of sodium."

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Alzheimer's debate: Test if you can't treat it? (AP)

PARIS � Picture yourself in Barbara Lesher's shoes: 54 years old and fearing you are developing Alzheimer's disease.

"I don't remember if I had a bath," said Lesher, who lives north of Harrisburg, Pa. "It took me two hours to follow a recipe. I drove to my childhood homestead the other week instead of my own home. It's really scary."

Doctors are arguing about whether to test patients for signs of the incurable disease and tell them the results.

The debate raged this past week at the Alzheimer's Association International Conference in France, where research on new methods � easier brain scans, an eye test, a blood test � made it clear there soon may be more such tools available.

Here's why it's an issue: Many people have brain plaques, suggesting they might be developing Alzheimer's even if they don't have any symptoms. This plaque can be seen decades beforehand and does not ensure someone will get the disease. Many also won't live long enough to develop symptoms.

For those who do have Alzheimer's, there are no good treatments. Current drugs ease symptoms � they work for half who try them and for less than a year on average. Most experts think treatment starts too late, but there's no evidence that starting sooner or learning you have brain plaque will help. Experts are divided.

"We have to look for patients or signatures of the disease at earlier stages," urged Dr. Harald Hampel of the University of Frankfurt, Germany.

But Dr. Kenneth Rockwood of Dalhousie University in Halifax, Nova Scotia, Canada, says there is no data "to show that knowing makes any difference in outcomes. Until we do, this is going to be a tough sell."

More than 35 million people worldwide have Alzheimer's, the most common form of dementia. In the U.S., more than 5 million do � 13 percent of those 65 and over, and 43 percent of those 85 and up, a rapidly growing group.

Still, half of people who meet medical criteria for dementia have not been diagnosed with it, the Alzheimer's Association estimates. And many who are told they have Alzheimer's or are assumed to have it really don't.

Even when researchers use the best cognitive tests to enroll people in clinical trials, about 10 percent ultimately are discovered not to have the disease, said William Thies, the Alzheimer's Association's scientific director.

"The Alzheimer's drugs don't work in these folks, so there's no reason to expose them to those risks," said Thies, long an advocate of early diagnosis.

Misdiagnosis is a lost opportunity to help. A new medication or combination of medications may suddenly make someone appear demented. Brain fog can occur after surgery and abate over time. Sleep problems are common in older people and can cause profound confusion that can be misinterpreted as dementia, according to research presented at the conference by Dr. Kristine Yaffe of the University of California, San Francisco.

"Some of these are treatable" by avoiding naps during the day or treating sleep apnea, in which brief interruptions of breathing cause people to wake during the night, Yaffe said. Snoring is a big sign. Older people with sleep problems are more likely to be put in nursing homes, she said.

Dr. R. Scott Turner, director of the memory disorders program at Georgetown University Medical Center, has seen that all too often.

"I'm certainly in the camp that screening should be done," he said. Many patients are simply declared to have dementia without testing to see if they have another condition.

"Sometimes it's thyroid disease, or depression, or vitamin B-12 deficiency � something that's very treatable," he said.

Testing someone with symptoms is far less controversial than testing people with no symptoms but a lot of fear. Doctors worry that these newer methods, such as an easier type of brain scan that's expected to be available within months, will be directly marketed to the public, prompting expensive and excessive testing based on fear.

"The phrase you often hear is that the 'Big A' (Alzheimer's) has replaced the 'Big C' (cancer)" as a major source of fear, said Dr. Jason Karlawish, a University of Pennsylvania ethicist specializing in dementia issues.

Recent guidelines by the U.S. National Institute on Aging and the Alzheimer's Association say these tests should be used only in research until they have been standardized and validated as useful and accurate tools.

A researcher using one of these tests, such as a spinal fluid check for a substance that may predict Alzheimer's risk, has no obligation to disclose the results to a patient until there is a meaningful treatment for the disease, Karlawish argued at the conference.

The more symptoms a patient has, the more justified it is to help understand what is known about possible reasons, he said.

Lynda Hogg of Edinburgh, Scotland, is very glad her doctors diagnosed her Alzheimer's in 2006. She is doing exceptionally well on one of the existing drugs and is in a clinical trial for an experimental one she hopes will help her and help advance knowledge in the field.

At a discussion connected with the conference, she said the early diagnosis helped her get financial and legal matters in order and serve on the Scottish Dementia Working Group and the board of Alzheimer's Disease International.

"I am certain involvement keeps me focused and involved in society," she said.

The Alzheimer's Association says early diagnosis and evaluation can bring the following benefits:

� Treatment of reversible causes of impairment.

� Access to drugs that help treat symptoms.

� Inclusion in clinical trials that give expert care.

� Avoiding drugs that can worsen cognition.

� Letting others know of a need for help managing medicines and daily life.

� Easing anxiety about the cause of symptoms.

� Access to education, training and support services.

� The ability to plan for the future.

Lesher, the woman from Pennsylvania, wishes she had a clearer picture of what lies ahead for her.

"Not being able to get diagnosed is the must frustrating thing in the world," she said.

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Online:

National Institute on Aging: http://www.nia.nih.gov/Alzheimers

Alzheimer's Association: http://www.alz.org

National Alzheimer's Plan: http://bit.ly/fFWWCT

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

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Lack of sperm coating plays role in infertility (AP)

WASHINGTON � Scientists have found a new contributor to male infertility, a protein that's supposed to coat sperm to help them swim to an egg, unless that coating goes missing.

About 20 percent of men may harbor gene mutations that leave their sperm coat-free and thus lower their fertility, an international research team reported Wednesday.

Today's reproductive tests can't spot the problem, said study co-author Dr. Theodore Tollner of the University of California, Davis.

"You would have no reason to think many of these men with the genetic mutation would have reduced sperm function," he said.

Anywhere from 10 percent to 15 percent of couples experience infertility, and doctors can't always find the cause. A lack of sperm or problems with their shape or ability to move explains only a fraction of infertility.

The California-led team found a new reason, a protein that's part of a family of germ-killing molecules found on the surfaces of a variety of tissues. It's secreted as sperm journey into the female reproductive tract, helping the sperm to penetrate the mucus in a woman's cervix and to avoid being tagged as an invader by her immune system.

Having two copies of a particular gene mutation means sperm cannot produce that coating. Lab tests show those sperm have a hard time making it through the mucus.

But how much does that affect fertility?

The researchers tracked 500 newly married Chinese couples attempting to conceive. The birth rate was 30 percent lower among couples with a husband who harbored that double mutation, scientists reported in the journal Science Translational Medicine.

Having just one copy of the mutated gene doesn't seem to hinder conception.

The coatless sperm don't always fail, so it's not clear just how much this issue contributes to male infertility overall.

But creating a test to diagnose these men would be easy, the researchers said. Such a test potentially would lessen the time that a couple having problems conceiving spends in limbo before trying treatments such as having sperm placed directly into the woman's uterus.

One day, a vaginal gel might even let sperm pick up the protein coating as it travels into the cervix. The California researchers say they're already trying that with animals.

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CDC: Frogs tied to salmonella being sold again (AP)

ATLANTA � A California company has resumed selling a kind of pet frog that caused salmonella illnesses in more than 240 people, most of them children. And federal health officials are not happy.

Centers for Disease Control and Prevention officials on Wednesday warned consumers that Blue Lobster Farms in June had resumed shipping African dwarf frogs from its Madera County, California, breeding facility. They say the frogs may still pose a serious health risk.

The company voluntarily stopped shipping the frogs in April, after an investigation fingered them as the source of a salmonella outbreak that sickened people nationwide over two years. No one died, but many illnesses were in children under 5 years old � some hospitalized.

Company officials could not be reached for comment.

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http://www.cdc.gov/salmonella/water-frogs-0411/

http://www.cdc.gov/media/matte/2011/05_waterfrogs.pdf

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