News in brief - May 24/31, 2004

WHO warns of diabetes' growing global impact - Plans change for Plan B - CDC sees burst of Lyme disease - Frequent ear infections in childhood linked to asthma

WHO warns of diabetes' growing global impact

As many as 3.2 million deaths are linked to diabetes annually, and six deaths a minute are due to the disease worldwide, according to the World Health Organization.

The statistics were included in "Diabetes Action Now," a WHO report issued this month to mark the launch of a program to combat the emergence of the disease in conjunction with the International Diabetes Foundation.

The estimates of the diabetes figures were based on the relative differences in the risk of death between people with diabetes and those without, and the numbers include deaths where the disease would have played some role.

"Diabetes is a major threat to global public health that is rapidly getting worse," said Dr. Catherine Le Gales-Camus, WHO assistant director general for noncommunicable diseases and mental health.

There were about 171 million diabetics in 2000, but the agency expects this number to grow to 366 million by 2030 driven primarily by a 150% increase in the rate of the disease in the developing world.

Plans change for Plan B

The Food and Drug Administration on May 6 rejected a proposal for over-the-counter sales of the emergency contraceptive known as Plan B despite the approval of two agency advisory panels earlier this year.

The FDA said that the manufacturer must either find a way to prevent girls younger than 16 from purchasing the drug without a prescription, or prove, in a study, that Plan B can be safely used by girls under age 16 without a physician's supervision.

Bruce L. Downey, chair and CEO of Plan B manufacturer, Barr Pharmaceuticals Inc., indicated that the firm plans to continue to work with the FDA and that the conditions set out by the agency would not prove insurmountable barriers to OTC sales.

"In the meantime, we remain committed to providing Plan B as a prescription-only product and to increasing awareness among the health care provider community and women of this safe and effective option," Downey said.

Plan B, or levonorgestrel, is a progestin-only pill that has been shown to reduce the risk of pregnancy if taken soon after unprotected sex.

The AMA, the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics support OTC availability.

Following the rejection, charges were quickly made that politics rather than science influenced the agency's decision. A spokesman for presumed Democratic presidential candidate John Kerry blamed the White House for putting its own political interests ahead of sound medical policies. Meanwhile, conservative groups hailed the decision as a responsible one that demonstrated concern for women's health.

CDC sees burst of Lyme disease

The number of cases of Lyme disease reported to the Centers for Disease Control and Prevention increased by 40% from 2001 to 2002 -- the highest level yet. The increase is likely due to more houses being built in wooded areas where the ticks that carry the disease are found, greater recognition of the disease and enhanced reporting, the CDC said.

During 2002, a total of 23,763 cases were reported to the CDC, most in the Northeast, the mid-Atlantic states and the North Central states. The largest proportion of cases were reported among 5- to 14-year-olds and among 50- to 59-year-olds.

In February 2002, the only Food and Drug Administration-approved vaccine was withdrawn from the market. But the CDC points to other effective measures to protect people living in tick-infested areas. They include repellent use and routine tick checks as well as reducing exposure by removing brush and leaf litter or creating a buffer zone of wood chips or gravel between forest and lawn or recreational areas.

Frequent ear infections in childhood linked to asthma

Children with a history of several ear infections are twice as likely to develop asthma as children who did not have such infections, according to finding published in the May issue of Chest.

Researchers at the University of Illinois, Chicago, analyzed data from the Third National Health and Nutrition Examination Survey looking at the association of ear infections to asthma or wheezing. They found that children who had never had an ear infection had an asthma rate of more than 6%, but more than 12% of those with a history of at least three such infections had the respiratory disease.

The authors of the paper theorized that either the bacteria or viruses causing the infections or the medications used to treat them could be causing asthma, and that the theory deserves additional study.

"It is possible that specific virus or bacteria that cause recurrent ear infections may play a major role in the development of asthma," said Kamal Eldeirawi, lead author and visiting research specialist in epidemiology and biostatistics. "It is also possible that antibiotics that are commonly used to treat ear infections increase the risk of asthma, but more research is needed."