Health Spectator

We first wrote about bisphenol-A (BPA) about two years ago. In that article, we noted that while parents were shying away from plastic baby bottles containing the substance, they were largely unaware that BPA was actually found in larger quantities in most liquid baby formulas because it leaches from the linings of the cans used to package them. Powdered infant formulas, because they needed to be diluted with water, were deemed likely to be a lower source of the substance, but by no means exempt from suspicion.

We recently came across the video below, which does a good job of explaining the dangers and sources of BPA. This substance is of concern not only for infant formulas, but for food packaging and preparation in general, since BPA is used in many plastics used to store and prepare food and beverages, as well as to line all cans sold in the U.S. Since BPA is a serious endocrine disruptor linked to both breast and prostate cancers and is found in the bodies of 93% of the U.S. population, this is bad news for Americans. Any soda you buy—because it will come stored either in a can or a plastic bottle—is likely to be contaminated with the substance. The same follows for virtually any packaged food or beverage, including, for example, canned vegetables. Yet, independent studies performed on BPA even in extremely low doses indicated that the chemical was disruptive to both male and female reproductive systems. It has been linked both to breast and testicular cancer.

This video follows the history of BPA and shows how the EPA has spent millions of taxpayer dollars earmarked for screening chemicals such as BPA without apparently doing anything. It also interviews scientists concerned with this toxic pollutant.

You may remember the case of Andrew Speaker. He went to Italy to be married and returned with a drug-resistant form of tuberculosis that caused a national furor and was reported on this website. The furor arose because Speaker traveled by plane with a highly contagious, hard-to-cure disease. At one point, Speaker was diagnosed by the CDC as having “extensively drug resistant tuberculosis.” That diagnosis was later downgraded to “multi-drug resistant tuberculosis.” Even so, Speaker was faced with a two-year regimen of drugs or surgery. He chose the surgery and recuperated, we are happy to report, without further complications.

While Speaker’s case became an instant sensation, the CDC and other public health officials managed to keep quiet a much more insidious form of the disease that appeared on our shores just a few months later, around September 2007. A 19-year-old student named Oswaldo Juarez came to the U.S. from Peru to study English. When he found himself coughing up blood, he knew something was very wrong.

He was diagnosed as having “extremely drug-resistant tuberculosis”—two cuts above the variety that Speaker had. After three months of futile treatment by a local hospital in Fort Lauderdale, he found himself living at the A.G. Holley State Hospital, the nation’s last tuberculosis sanitarium, located just south of West Palm Beach.

After approximately a two-year regimen not unlike chemotherapy for cancer, Juarez was pronounced cured and allowed to leave the facility. That was in July of this year. After 19 months of treatment at A.G. Holley, Juarez was now 21 and fluent in English.

The Associated Press reports that the Florida taxpayers paid about $500,000 for his treatment, which nonetheless was money well spent, since had he not been treated he most likely would have infected others and might have started an epidemic of virtually incurable tuberculosis had he continued to live in the U.S. or attempted to return home to Peru. According to AP reports, doctors had apparently told him he might only live about a month if he returned to Peru.

The Taiwan News is reporting that a gynecologist identified only as Dr. Liu plans to sue the Centers for Disease Control in Taiwan over the death of his seven-year-old son in the wake of an H1N1 vaccination the child was given at school on November 19.

The case has been made public by Chang Yao-tsung, an opposition Democratic Progressive Party member of the Taichung City Council, speaking on behalf of the child’s parents.

The report says the child had no previous history of medical problems. Like many cases linked by parents to vaccinations, this one began with almost immediate symptoms. The child began suffering with red blotches on the soles of his feet the day following the vaccination. A private clinic diagnosed the condition as either an allergy or a reaction to the shot. Over the following two weeks, despite treatment with medications, the blotches spread over the child’s entire body. The frantic parents moved him from hospital to hospital, demanding ever more expensive treatments and tests. Some doctors said that the child’s immune system was not functioning properly. Despite all efforts, the child died yesterday, December 21. The official diagnosis was sepsis, commonly known as blood poisoning.

We cite the following directly from the Taiwan News:

A total of almost 4.8 million people had been vaccinated so far, according to CDC statistics.

Including the boy, a total of four deaths were recorded following inoculation, including men aged 82 and 50 respectively who had difficult health histories, and a high school student, reports said.

Five pregnant women were reported with problems ranging from miscarriage to a stillborn infant.

Of… 331 lighter cases, 43 percent were dizzy after being inoculated, 20 percent registered a fever, 18 percent felt ill, 17 percent had a headache and 11 percent vomited, according to CDC data.

The CDC denies that the boy’s sickness and death had anything to do with the H1N1 vaccination.

There’s a new report out that says mercury fillings—the so-called “silver” dental amalagam most of us have in our teeth—may not be so harmful after all. Using x-ray analysis, Graham George of the University of Saskatchewan analyzed the surface of mercury-based fillings that were about 20 years old and compared those to the surface of new amalgam fillings.

The old fillings had lost up to 95 percent of their mercury. What’s more, their mercuric composition had changed. While new fillings contain metallic mercury, the old ones contained primarily beta-mercuric sulfide (metacinnabar), according to the paper George and colleagues published in the American Chemical Society journal, Chemical Research in Toxicology in late October.

Over the past week or so, that paper’s conclusions have been finding their way into the scientific press. So maybe those mercury fillings aren’t so toxic after all, the journalists have been saying. At least, not after they’ve been in your mouth for about 20 years.

The only problem is that the harm scientists have been claiming from amalgam fillings comes from the mercury vapors given off by those fillings, not by the direct action of food or saliva against the fillings themselves. Mercury vapor is what put the “mad” in mad hatters, a nineteenth-century reality independent of the writings of Lewis Carroll. Indeed, the primary reason mercury thermometers have become so rare is that if one breaks, despite the low vapor pressure of mercury, the air of a small room such as a bathroom can easily exceed the acceptable limit of the dangerous fumes, even at room temperature. When mercury is heated, the vapors become far more toxic. What’s more, the lungs provide the most efficient path for absorption of mercury.^{1 2 3}

So while we believe the authors of this article had good intentions, we reject the notion that mercury fillings are not harmful. If after 20 years most of the mercury from those fillings is gone, where do you suppose it went? Probably into your body, a substantial portion of it absorbed through your lungs and digestive tract as inhaled fumes.

Represetative Earl Blumenauer has posted an open letter to his fellow members of Congress over on Huffington Post. For your convenience, we’ve posted the text here:

Senators who are filibustering and throwing sand in the gears to delay health care reform desperately need a reality check. It is ironic to me that members of Congress enjoy some of the best health insurance in the world through our government-administered health care, and yet so many are working overtime to deny quality care to Americans – using scare tactics to claim the “government is going to take over their health care.”

Well, for those Representatives and Senators who are so terrified of a government take-over, I say to them NO access to government run programs for you.

Members of Congress should not have access to taxpayer-funded health care when they are actively denying these very people quality care of their own.

So for the 150 members of Congress who qualify for Medicare, a single-payer government insurance plan, you get no access.  For all members who are eligible for the Federal Employee Health Benefits Program, no more. And no more access to the attending physician in the Capitol, either. Not until we pass the health insurance reform that millions of Americans so urgently need.

I share with you my open letter to members of Congress:

Dear Colleague,

I invite you to join me in sponsoring the Health Care Reality-Check Act which I will be introducing next week.

It has become clear that some of our colleagues lack proper perspective on the urgency of health reform because, ironically, as members of Congress we enjoy some of the best health security in the world through our government-administered health care:

• All Members of Congress are eligible – and most participate in – the Federal Employee Health Benefits Program, which provides all federal employees with a government-negotiated insurance exchange that is subsidized by their employer: the Federal Government;
• Almost 150 Members of Congress qualify for Medicare, a single-payer government insurance plan;
• The 121 Senators and Representatives who served in our armed forces are eligible for the “socialized” health care we provide for all veterans; and
• Members who aren’t veterans can avail themselves to a similar “socialized” program – the Attending Physician in the U.S. Capitol, for an annual fee of around $500.

These government-run health programs have successfully provided countless Senators and Representatives with life-saving medical treatments, but as we all know, most Americans don’t have this kind of protection.

Members of Congress should not have access to taxpayer-funded healthcare when they are actively denying these very people quality care of their own.

Congress needs a reality check.

In 2007, before the economy collapsed, 42% of all adult Americans under 65 were either uninsured or underinsured.  Our dire unemployment rates and escalating health care costs have only made this situation worse.  Today half of all American families delay seeking medical treatment because they have such a tenuous health insurance situation.   Our colleagues do not fully appreciate the plight of 50% of our population, but we can help them understand.

Until health reform is enacted, Members of Congress should get to experience the tender mercies of our fragmented, complex, and exploitative health care system.  My Health Care Reality Check Act terminates all government-administered health benefits for Members of Congress until comprehensive health reform is signed into law:  no more Federal Employee Health Benefits Program, no Medicare, no VA, no attending physician in the Capitol.

Instead, Senators and Representatives may self-insure or they can rely on a spouse’s company having employer-provided insurance, thus tying them –  like millions of Americans- to the employment of a family member. Some will need to buy health insurance on the private market, exposing them to legal discrimination based on age and gender.

By personally dealing with rescissions, pre-existing condition exclusions, the fine-print of insurance contracts and the gaps in coverage from weak consumer protections maybe our colleagues can better grasp the urgency of our health care crisis.

If our own health security were linked to the success of health reform for all Americans, we [would] have a bill enacted within weeks, guaranteed.  I urge you to cosponsor the Health Care Reality Check Act today.

To your health,

Earl Blumenauer

Instead, Medicare may open to those 55 and older

In a surprise move to appease moderate Democrats, sources say the Obama health reform plan may drop the public option in favor of extending Medicare to the uninsured who are more than 55 years of age, the Associated Press is reporting. Currently, only those over 65 are eligible to receive Medicare.

At a last-minute news conference in the Capitol Tuesday evening, Senate Majority Leader Harry Reid (D-Nev) would say only that a “broad agreement” had been reached between liberals and moderates on the issue. The resulting bill is expected to forbid insurance companies to deny coverage based on pre-existing conditions and to reduce healthcare costs in general.

However, dropping the public option is seen as a great loss by those who wish to see healthcare needs prevail over insurance-industry profits. And it seems less likely costs will be curtailed if a purely private health insurance solution is formulated. Currently, about 20% of every healthcare insurance dollar the public pays out goes to insurance industry profits and overhead. The competition provided by the public option was seen as a way to lower these costs and see that more of the healthcare dollars coming both from taxes and individual expenditures would go toward providing actual health care. Medicare overhead costs are generally considered to be between two and five percent, with four percent the most popular figure.

One undoubted benefit of increasing the Medicare rolls is that it will increase the scrutiny paid to Medicare and its benefits. Currently, Medicare recipients are saddled with recent additions to the plan that operate like private insurance or require recipients to sign up for private insurance if they wish to receive, for example, payment for drugs. Some recipients claim that the copays under these plans exceed the cost of many generic drugs purchased directly from a low-cost pharmacy.

Increasing the number of people dependent on the program may increase political pressure to return Medicare more to its single-payer roots.

If you’ve made it this far, chances are better you won’t be getting the swine flu. The fall wave has peaked, experts seem to agree, and while there will surely be more cases to come, they are on the wane. The Centers for Disease Control and Prevention (CDC) is warning that another (winter) wave may occur in January, possibly prompted by students returning home from college during the Christmas holidays, but thus far, the flu pandemic has been a relative non-event as flu pandemics go.

So far, pandemic H1N1 is still crowding out other influenzas, such as seasonal H1N1 and H3N2. Since September, the CDC has tested 420 patient samples that were positive for influenza, and of those, only eight were not pandemic H1N1. Indeed, only one was seasonal H1N1.

The dominance of pandemic flu has not been good for the youngest age groups, however. During week 46 of 2009 (the last for which CDC figures have been reported) 35 influenza-related pediatric deaths were reported. Twenty-seven of these deaths were associated with pandemic H1N1 infections, seven were due to an undetermined influenza A virus subtype, and one was associated with a seasonal H1N1 infection that occurred in March.

Clearly pandemic H1N1 has been harder on children and teenagers than on older people. The H3N2 virus, on the other hand, tends to kill the elderly. But only three cases of H3N2 were reported out of the 420 patient samples previously mentioned, meaning that the pandemic flu’s tendency to crowd out other strains has spared the older age groups, relatively speaking.

Since April, the H1N1 outbreak has killed about 4,000 Americans, according to CDC estimates, of which at least 230 were children under the age of 18.

Even the Centers for Disease Control and Prevention (CDC) admits it: H1N1 swine flu is a mild disease for most people, but for those whom it hits hard, it is often fatal.

Approximately a third of those who die from the disease do so because of other complications—generally pneumonia or MRSA (methicillin-resistant Staphylococcus aureus) so that the two primary killers once H1N1 gets involved are S. aureus and S. pneumoniae.¹ In part, this reflects the fact—reported here earlier²—that pandemic H1N1 tends to go deeper into the lungs than seasonal flu. According to Dr. Sherif Zaki, a pathologist at the CDC quoted in the November issue of Nature,³ this particular property of the virus is similar to H5N1 avian flu, a far more virulent form of flu that scientists have feared for years might take on a highly contagious human form.

The good news is that this particular scenario has been slow to develop in nature, and may prove difficult to replicate even in the lab. Researcher Bruno Lina at the Jean Merieux/INSERM biosecurity facility in Lyon, France proposes to try to force recombination of H1N1 and H5N1 in the lab and test the survivability and virulence of any resulting products. Based on some of his previous attempts to reassort H5N1 with seasonal H1N1 and H3N2 and the fact that the two viruses in question are different subtypes, he doesn’t expect to find reassortments that are survivable.

Referring to his previous experiments with reassorting H5N1, Lina told Nature, “After a year we only had three reassortments, and none was fit. They just don’t reassort well.”⁴

Even as a feeding frenzy surrounds the H1N1 swine flu vaccine, New Yorkers were confronted with the news that Wall Street banking firms Goldman Sachs and Citibank were given 200 doses of swine flu vaccine—the same quantity given to Lenox Hill Hospital.

Goldman and Citibank were not the only corporations given doses of the vaccine, and any companies receiving the vaccine had to have their own medical personnel in place. Also, the understanding was that the vaccinations would be given only to employees in the highest-risk groups, which includes pregnant women, children, and those with chronic diseases such as asthma.

Although the Centers for Disease Control and Prevention (CDC) is widely credited with the apparent gaffe, sources say the CDC gave the vaccine doses to the state, which dispensed them to hospitals, doctors, and corporations.

The video below from NBC’s Today show, summarizes the whole issue quite well, we think. For a more humorous approach to the subject, check out the Saturday Night Live clip below that.

Friday happens to be Malaria Day in the Americas 2009, and while malaria is not much of a problem here in the United States, it does affect our neighbors to the south and is a major problem in Africa. So we thought we’d take the time to acquaint you with the issues.

Malaria kills more than one million people a year, most of them children. (Most of the remaining fatalities are pregnant women.) Somewhere between 350 million and 500 million people are infected with malaria annually, at great economic cost, especially to families, since breadwinners are often unable to work for weeks, even if they eventually recover.

The main efforts being taken to combat malaria involve encouraging the use of bed nets in malaria-infested regions, particularly long-lasting insecticide-treated bed nets, which are the state of the art, and combating antimalarial resistance. So far, resistance to antimalarials —the ineffectiveness of malaria medications due to evolving strains of malaria that are not killed by them—has cost us the use of the cheapest and all but the very best antimalarial medications. Indeed, the World Health Organization (WHO) has mandated that artemisinin, the best of the antimalarials available currently, not be given as a monotherapy. In other words, artemisinin must be adminstered with at least one other antimalarial drug to comply with WHO guidelines.

In the Americas, targets for 2015 include:

• Decreasing annual malaria cases from approximately 1.15 million in the year 2000 to 575,000 by 2010 (50% reduction) and to 287,000 by 2015 (additional 25% reduction)
• Reducing malaria deaths from 348 in the year 2000 to less than 174 (50% reduction) by 2010 and to less than 87 (additional 25% reduction) by 2015

The effectiveness of long-term malaria control is governed by the strength of health systems. Strong health systems can deliver effective, safe, high-quality interventions when and where they are needed and assure access to reliable health information and effective disease surveillance. At the same time, integrating malaria treatment, prevention and surveillance into existing health programs and activities in endemic countries will ensure that funding earmarked for malaria control contributes to the development, expansion and continuous improvement of national health systems.

While the malaria situation in Africa is particularly dire, in the Americas there have been some successes since the turn of the century. Specifically, between 2000 and 2008, we have seen

• a 50.4% reduction of malaria cases in the region
• Approximately a 77% reduction in malaria mortality
• Seven countries have witnessed a greater than 75% reduction in annual malaria cases
• Five countries have shown a reduction in annual malaria cases between 50% and 74%
• Six countries have decreased annual malaria cases by less than 50%

Just in the Americas, the investment needed for malaria control and elimination are $227 million in 2009 and $261 million in 2010.