Monthly Archives: May 2016

Bird flu cases in Europe

More outbreaks of a severe strain of bird flu in Europe are likely to occur in the next few weeks as wild birds believed to transmit the virus migrate southward, the deputy head of the world animal health body said on Tuesday.

North America, especially the United States where bird flu last year led to the death of about 50 million poultry, should also prepare for new cases, said Matthew Stone, Deputy Director General of the World Organisation for Animal Health (OIE).

Eight European countries and Israel have found cases of the highly contagious H5N8 strain of bird flu in the past few weeks and some ordered that poultry flocks be kept indoors to avoid the disease spreading.

Most outbreaks involved wild birds but Germany, Hungary and Austria also reported cases in domestic duck and turkey farms where all poultry had to be culled

“From the level of exposure that we have seen to date I would expected more detections, hopefully only in wild birds but it is certainly possible that the presence of this virus in wild birds will create an opportunity for exposure in domestic poultry,” Stone told Reuters in an interview.

“The OIE is very concerned for the impact on our member countries and particularly those where there has been exposure of domestic poultry and where significant control operations are underway,” he added.

Wild birds can carry the virus without showing symptoms of it and transmit it to poultry through their feathers or feces.

The H5N8 virus has never been detected in humans but led to the culling of millions of farm birds in Asia and Europe in 2014.

REDUCING RISKS

In the United States the bird flu crisis last year sent egg prices to all-time highs because of the losses and dozens of countries imposed total or partial bans on U.S. poultry and egg imports.

It would be “no surprise at all” to see new detections in wild birds in North America, Stone said, adding that he hoped the biosecurity framework set up by the U.S. industry and the government would reduce the risk of large-scale outbreaks.

“At this stage we have to take history as our best indicator of what may well play out over the next few months,” Stone said.

Bird flu cannot be transmitted through food. The main risk is of a virus mutating into a form that is transmitted to and between humans, potentially creating a pandemic.

All about the regnancy diabetes

Pregnant women with pregnancy-related diabetes are less likely to achieve blood sugar control if they rely on food stamps or have a generally chaotic lifestyle, according to a U.S. study.

These kinds of factors may be modifiable, the authors write in Obstetrics and Gynecology.

“Many social factors have a major impact on overall pregnancy health,” said Dr. Laura Colicchia, who led the study at the University of Pittsburgh and is currently in Maternal-Fetal Medicine at Abbott Northwestern Hospital in Minneapolis.

About 200,000 U.S. women develop diabetes during pregnancy each year, Colicchia said, and they must follow a strict diet, prick their fingers four times daily to check blood sugar, report their blood sugars to the doctor weekly, have frequent office visits and ultrasounds, and in many cases take insulin or medications several times daily to control their sugars.

“Gestational diabetes impacts every aspect of a woman’s life including eating with and cooking for her family, scheduling her blood sugar checks and meals at work, where she obtains the food to follow the diet and how she creates time for everything,” she said.

“Because of this, barriers to management of diabetes can come from any part of her life including her family, her neighborhood, her daily routine or her employer,” she told Reuters Health by email.

Women who are obese, have limited access to food or are from marginalized communities are at higher risk for gestational diabetes and often have higher blood sugar levels when diabetes is diagnosed making it harder to control, Colicchia noted.

The researchers surveyed 111 women with gestational diabetes at clinical visits, using questionnaires designed to measure social support and degree of life “chaos,” which includes organization, stability and the ability to plan and prepare for the future.

They later analyzed medical records for blood sugar control and pregnancy outcomes, including infant size, maternal weight gain, cesarean delivery and newborn health.

Women were rated as having good blood sugar control if at least 70 percent of their blood sugar assessments were at goal level or better.

Overall, 86 of the 111 women achieved good glycemic control, either by diet changes alone or with the help of medication and insulin treatment. These women were more likely to be married, have higher household income and exercise three times a week, and less likely to have public insurance or a history of depression or anxiety.

Heart failure drug

The cost of generic drugs that treat heart failure can vary so wildly, even among pharmacies within one area, that uninsured patients may not be able to afford them, according to research reported at the American Heart Association medical meeting in New Orleans on Tuesday.

Researchers found that the combined cost for a month’s supply of three commonly prescribed generic heart failure drugs ranged from $12 to $400, with an average price of about $70 in the greater St. Louis area, putting them out of reach for some patients who desperately need them.

About 5.7 million Americans are living with heart failure, according to the AHA. The condition, in which the heart no longer pumps efficiently enough to supply the body’s blood and oxygen needs, is one of the most common causes of hospitalization in people aged 65 and older and often requires treatment with multiple medications.

Prompted by a 25-year-old patient who said he could not afford to fill his prescription for digoxin at $100 for a 30-day supply, Dr. Paul Hauptman decided to look into the variable cost of supposedly cheaper generic heart failure medicines.

“I think a lot of doctors assume that if you’re writing a prescription for a generic drug, that it will be affordable,” said Hauptman, a heart failure specialist at St. Louis University School of Medicine.

Researchers surveyed 175 pharmacies in the St. Louis area to see how much they charged uninsured customers for digoxin, lisinopril and carvedilol. The researchers found no apparent link between price and type of pharmacy or the average income in a particular neighborhood. They even found that two major pharmacy chains did not have consistent pricing between their stores.

“We do not know where the major pricing problem lies in the journey that a generic drug for heart failure takes from generic company to distributor to retail pharmacy and then to patient. There is no transparency here,” Hauptman said.

Uninsured patients typically do not shop around for lower prices, Hauptman said, adding that if a patient finds a drug too expensive, “they don’t fill the prescription.”

He suggested this type of study be replicated in other parts of the country and for other medical conditions.

Former AHA President Dr. Clyde Yancy, who was not involved with this research, said the issue affects everyday life of patients he treats who are on fixed incomes.