Friday, August 12, 2011

Bat on Wisconsin flight prompts rabies probe (AP)

ATLANTA � Health officials say a bat on a flight from Wisconsin to Atlanta last week has sparked a national search for passengers to protect them against possible rabies.

Officials don't know if the bat had rabies. It escaped. But they want to alert passengers of the risk just in case. The Centers for Disease Control and Prevention says it is trying to reach all 50 people who flew on Delta flight 5121, which departed from Madison, Wis., to Atlanta at 6:45 a.m. on Aug. 5.

If the animal was rabid, people could catch rabies from a bite or exposure to the bat's saliva.

CDC officials asked anyone on the flight to call 1-866-613-2683. The airline didn't retain the records for all the passengers.

The jet was in the air when the winged animal emerged and a passenger shot a video. Operators of the flight said it could have been a bird. But CDC says its rabies expert believes from the video that it was a bat.



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UN says cholera epidemic in Somalia (AP)

GENEVA � World Health Organization officials said Friday that famine-hit Somalia faces a cholera epidemic as dirty water and poor sanitation are leading to an increase in outbreaks of the disease.

Officials say cases of acute watery diarrhea � an important indicator of the risk of cholera � are now at 4,272 in Somalia � an 11 percent rise on last week's WHO reported figure of 3,839.

WHO public health adviser Dr. Michel Yao told reporters in Geneva on Friday that the number of cholera cases has also risen sharply this year, with officials confirming 18 cases in the 30 lab samples taken in recent days from people living in the capital, Mogadishu.

Yao said the 60 percent infection rate confirms there is a "high risk" of the disease spreading quickly � "so we can say we have an epidemic."

The random samples, which were tested in a lab in the capital, were drawn from among 4,272 samples from people who have suffered the diarrhea, he said. So far, he said, there have been 181 acute watery diarrhea-related deaths.

WHO spokeswoman Fadela Chaib said last week that a few cases of cholera have been confirmed in Somalia and the diarrhea is also on the rise. She said of the 3,839 reported cases, 77 percent afflicted children younger than 5-years old in Mogadishu.

The World Health Organization has said it is very concerned about disease outbreaks in drought-hit East Africa, due to a lack of clean water for drinking and bathing, overcrowding in camps and the low tolerance to disease of starving young children.

The United States estimates drought and famine in Somalia have killed more than 29,000 children under the age of 5. Millions face the risk of starvation amid Somalia's worst drought in 60 years.

UNICEF spokeswoman Marixie Mercado said Friday that tens of thousands of children have died and countless more are particularly at risk of cholera and other diseases because of drought and violence in East Africa.



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Thursday, August 11, 2011

'Amazing' normalcy for those with face transplants (AP)

They savor pizza and burgers, no longer frighten children, and many of them can walk the streets without people knowing they have someone else's cheeks, nose, lips and skin. People who have had face transplants increasingly are going public, helping to transform an operation that six years ago was daredevil theory into one that is widely accepted.

At least 18 face transplants have been done around the world, starting with a French woman mauled by her dog in November 2005, said Dr. Maria Siemionow, at Cleveland Clinic. She did the first face transplant in the U.S. in December 2008.

Brigham and Women's Hospital in Boston has done three this year alone. The U.S. Department of Defense is providing money for more of these surgeries in Cleveland and Boston in hopes of helping soldiers disfigured in battle. The University of Pittsburgh plans to offer face transplantation soon.

"It isn't mainstream yet. It's a last resort surgery," said Michael Cunningham, a psychologist at the University of Louisville, a pioneer in hand transplantation. But the face transplant experience so far shows that "there were a lot of naysayers and worries that just didn't seem to come to pass," he said.

On Thursday, the Boston hospital released a photo taken last month of Charla Nash, a Connecticut woman mauled by a chimpanzee. She had a face transplant in May.

"I will now be able to do things I once took for granted," Nash said in a statement. "I will be able to smell. I will be able to eat normally. I will no longer be disfigured. I will have lips and will speak clearly once again. I will be able to kiss and hug loved ones. I am tremendously grateful to the donor and her family."

Not all face transplant recipients have recovered hoped-for capabilities yet, and some have less than stellar aesthetic results although they are all vastly improved from how they looked before. The more recent ones in particular, where full rather than partial transplants have been performed, have fared especially well.

"They look from the very beginning quite natural and quite normal," said Dr. Bohdan Pomahac, who has performed four face transplants at Brigham. The most touching moment for him was a recipient texting him nine days after the operation, asking for a place to get good sushi in Boston.

"The level of normalcy," and to consider going out in public so soon, is "amazing," Pomahac said.

Here's how some others have fared:

_Dallas Wiens, a 25-year-old Texan severely disfigured in a power line accident, looked like a sock of flesh had been pulled over his face � no eyes or nose and barely a mouth. After his transplant earlier this year in Boston, he said the first thing his young daughter told him was "Daddy, you're so handsome." He said his new face felt "natural," and that right away he could smell the hospital's lasagna.

_Connie Culp, 48, an Ohio woman who was the first U.S. face transplant recipient, has made several television appearances and become an advocate for organ donation. Doctors have refined the droopy jowls and extra skin they purposely left to make checkup biopsies easier, and she now has "a normal face," Siemionow said. "She's smiling, she's perfect. When she jokes, she kind of flickers her eyes. Her face is vivid. You can see emotions."

_Mitch Hunter, 30, of Indiana, wore a prosthetic nose and had a distended, lopsided jaw after being disfigured in an accident. Now, he could pass you on the street and you wouldn't guess he has a new face, so good is his cosmetic result.

The successes have led more hospitals to approve face transplant protocols.

"We're currently screening patients," said Dr. Joseph Losee of the University of Pittsburgh. Carefully selecting appropriate patients "is the most important thing," he said.

So far, only two face transplant-related deaths have been reported, said Dr. John Barker, former director of plastic surgery research at the University of Louisville who is now a reconstructive medicine researcher at the University of Frankfurt in Germany.

One was a Chinese man who reportedly was not given or did not take medicines to prevent his body from rejecting his new face. The other was in Paris, a man who received a face and a double hand transplant. He suffered a heart attack during surgery to address a complication, Barker said.

Overall, "I think it's gone fabulously," he said of face transplantation. "It is a clinical alternative now, not experimental," he said. "It's been done and it works. For a select group of patients, it is a viable treatment."

___

Online:

Chimp attack woman: http://bit.ly/kcxTfi

___

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



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Face transplants becoming more common, accepted (AP)

More face transplant recipients and donor families are going public. They are boosting acceptance of an operation that six years ago was just daredevil theory.

On Thursday, a Boston hospital released a photo of Charla Nash, the Connecticut woman mauled by a chimpanzee. She had a face transplant in May. Other people who have had face transplants are now able to walk the streets without people knowing they have someone else's face.

Eighteen such transplants have been done worldwide. The first was in November 2005 on a French woman mauled by her dog. The first in the U.S. was in December 2008 in Cleveland. A Pittsburgh hospital hopes to offer them soon. The U.S. Department of Defense is funding more in hopes of helping disfigured soldiers.



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Wednesday, August 10, 2011

'Amazing' therapy wipes out leukemia in study (AP)

NEW YORK � Scientists are reporting the first clear success with a new approach for treating leukemia � turning the patients' own blood cells into assassins that hunt and destroy their cancer cells.

They've only done it in three patients so far, but the results were striking: Two appear cancer-free up to a year after treatment, and the third patient is improved but still has some cancer. Scientists are already preparing to try the same gene therapy technique for other kinds of cancer.

"It worked great. We were surprised it worked as well as it did," said Dr. Carl June, a gene therapy expert at the University of Pennsylvania. "We're just a year out now. We need to find out how long these remissions last."

He led the study, published Wednesday by two journals, New England Journal of Medicine and Science Translational Medicine.

It involved three men with very advanced cases of chronic lymphocytic leukemia, or CLL. The only hope for a cure now is bone marrow or stem cell transplants, which don't always work and carry a high risk of death.

Scientists have been working for years to find ways to boost the immune system's ability to fight cancer. Earlier attempts at genetically modifying bloodstream soldiers called T-cells have had limited success; the modified cells didn't reproduce well and quickly disappeared.

June and his colleagues made changes to the technique, using a novel carrier to deliver the new genes into the T-cells and a signaling mechanism telling the cells to kill and multiply.

That resulted in armies of "serial killer" cells that targeted cancer cells, destroyed them, and went on to kill new cancer as it emerged. It was known that T-cells attack viruses that way, but this is the first time it's been done against cancer, June said.

For the experiment, blood was taken from each patient and T-cells removed. After they were altered in a lab, millions of the cells were returned to the patient in three infusions.

The researchers described the experience of one 64-year-old patient in detail. There was no change for two weeks, but then he became ill with chills, nausea and fever. He and the other two patients were hit with a condition that occurs when a large number of cancer cells die at the same time � a sign that the gene therapy is working.

"It was like the worse flu of their life," June said. "But after that, it's over. They're well."

The main complication seems to be that this technique also destroys some other infection-fighting blood cells; so far the patients have been getting monthly treatments for that.

Penn researchers want to test the gene therapy technique in leukemia-related cancers, as well as pancreatic and ovarian cancer, he said. Other institutions are looking at prostate and brain cancer.

Dr. Walter J. Urba of the Providence Cancer Center in Portland, Ore., called the findings "pretty remarkable" but added a note of caution because of the size of the study.

"It's still just three patients. Three's better than one, but it's not 100," said Urba, one of the authors of an editorial on the research that appears in the New England Journal.

What happens long-term is key, he said: "What's it like a year from now, two years from now, for these patients."

But Dr. Kanti Rai, a blood cancer expert at New York's Long Island Jewish Medical Center, could hardly contain his enthusiasm, saying he usually is more reserved in his comments on such reports.

"It's an amazing, amazing kind of achievement," said Rai, who had no role in the research.

None of the three patients wanted to be identified, but one wrote about his illness, and his statement was provided by the university. The man, himself a scientist, called himself "very luck," although he wrote that he didn't feel that way when he was first diagnosed 15 years ago at age 50.

He was successfully treated over the years with chemotherapy until standard drugs no longer worked.

Now, almost a year since he entered the study, "I'm healthy and still in remission. I know this may not be a permanent condition, but I decided to declare victory and assume that I had won."

___

Online:

New England Journal: http://www.nejm.org

Science journal: http://stm.sciencemag.org



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BULLETIN KILL (AP)



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