News in brief - Nov. 3, 2003

Lung cancer screening associated with smoking cessation - Public health response to anthrax was good; clinicians hard to reach - HHS awards millions for primary care AIDS/HIV prevention and treatment - Flu vaccines for the youngest kids

Lung cancer screening associated with smoking cessation

Screening for lung cancer in smokers with low-dose fast spiral chest CT may increase the urge to quit, according to a paper released online Oct. 20 in advance of its publication in the December issue of the journal Cancer. Such screening is not currently endorsed by any major medical society but is marketed directly to smokers.

Researchers at the Mayo Clinic in Rochester, Minn. followed more than 900 smokers and more than 500 nonsmokers who were screened. At the end of one year, 14% of smokers had quit and more than 90% of nonsmokers were still abstinent. Both numbers were higher than expected. Cessation rates for smokers are estimated at 5% to 7% per year.

"Lung cancer screening may provide an opportunity for providing nicotine dependence intervention," wrote the authors.

Smokers also were more likely to quit if they were older and had poorer lung function. Nonsmokers were more likely to remain so the longer they were abstinent before the screening.

Public health response to anthrax was good; clinicians hard to reach

The response by public health agencies to the anthrax attacks in the fall of 2001 was effective, but problems arose because of the unexpected need for coordination between agencies. There also were significant problems getting pertinent information rapidly to clinicians, according to an October report issued by the General Accounting Office.

"No method [of communication] worked well for all targeted recipients," the report said. "E-mail worked well for institutions, but it was an ineffective way of communicating with physicians. ... Some primary care physicians were difficult to reach by any mass communication method or even individually."

The report also found that despite the effective response that staff and resources were severely strained and could not have been sustained for much longer. The incident also highlighted the lack of effective weapons against anthrax such as vaccines or drugs, and a lack of training for physicians in how to respond to the bioterror agent.

HHS awards millions for primary care AIDS/HIV prevention and treatment

Health and Human Services awarded more than 50 grants totaling $21.5 million to develop new HIV prevention strategies and treatment for those living with the infection.

"We have learned much about HIV/AIDS since the 1980s, but we still have a long way to go to prevent the spread of HIV and to ensure people in need get appropriate care," said HHS Secretary Tommy Thompson. "Armed with the knowledge learned through these grants, we will be able to share best practices and improve care in communities across the country."

More than $4 million will go to developing behavioral interventions in primary care setting to reduce the chance of people who already have the virus sharing it with others. More than $10 million will support early intervention for HIV and primary care services for those who are low income and medically underserved. Grants worth $4 million are being awarded to develop models that bring those who are HIV-positive into care, and another $2.15 million will go to support programs for Caribbean-Americans living with the virus.

Flu vaccines for the youngest kids

Children 6 months to 23 months old should be vaccinated annually against influenza beginning next year, said the Advisory Committee on Immunization Practices in an Oct. 15 recommendation. The ACIP had previously encouraged physicians to vaccinate 6- to 23-month-old children when feasible; that is, when they had the resources and capacity to educate parents about influenza, to administer the needed doses and to monitor vaccine adverse events.

The current inactivated influenza vaccine is not approved by the Food and Drug Administration for use among children younger than 6 months.

Two doses of inactivated influenza vaccine administered more than one month apart are recommended for previously unvaccinated children younger than nine years of age. If possible, the second doses should be administered before December. All subsequent annual influenza vaccinations require only one dose of vaccine.

The recommendations of the ACIP are forwarded to the director of the Centers for Disease Control and Prevention and the secretary of Health and Human Services for review. If the ACIP recommendations are accepted by both, they are published in the Morbidity and Mortality Weekly Report and become recommendations of the CDC.

The National Foundation for Infectious Diseases strongly supported the new recommendations. "Healthy children in this age range actually have as great a risk for being hospitalized due to flu-related complications as those who are 65 years of age and older, a group already targeted for annual flu vaccinations," said William Schaffner, MD, chair of the Dept. of Preventive Medicine at Vanderbilt University School of Medicine, Nashville, Tenn., and spokesperson for the foundation.