News in brief - Sept. 13, 2004

HHS' pandemic plan on vaccines, flu - U.S. sees care as primary importance - Contraception risk of STDs - NIH releases strategy for obesity epidemic fight

HHS' pandemic plan on vaccines, flu

Global surveillance, the rapid development and production of effective vaccines and an adequate stockpile of antivirals are among the issues covered in the Dept. of Health and Human Services' pandemic influenza preparedness plan unveiled Aug. 26.

The plan is a draft and can be found online (www.hhs.gov/nvpo/pandemicplan). Comments on it are being accepted through October.

The plan includes increasing the demand for annual flu vaccines to help improve annual levels of flu protection, strengthening the vaccine delivery system and helping expand manufacturing capacity to meet this increased demand.

There are only three U.S.-licensed manufacturers producing influenza vaccine, just two with all or part of their production process located in the country.

The plan also covers the need to have in place containment measures such as isolation and quarantine and limits on travel to slow disease spread and to gain time to develop a vaccine and distribute antiviral medications.

Three pandemics have occurred during the 20th century, with the 1918 Spanish flu pandemic being the worst by far, resulting in about 675,000 deaths in the United States.

The most recent candidate for a possible pandemic flu is an avian strain that has killed some people in Asia. Experts fear that if the strain jumps to humans and develops the ability to be transmitted from person to person, a pandemic could occur.

U.S. sees care as primary importance

Americans made an estimated 890 million visits to physicians in 2002, and about six out of every 10 of those visits, or 560 million, were to primary care doctors, according to a new Centers for Disease Control and Prevention study.

About 20% of all visits were to surgical specialists such as orthopedic surgeons and urologists, and about 17% were to medical specialists, such as allergists and dermatologists.

Primary care physicians, who can be general practice physicians, family physicians, internists, pediatricians, obstetricians or gynecologists, preformed nine out of every 10 preventive care visits, which were likely to include diagnostic and screening services, said the study.

About 20% of primary care doctors made one or more home visits during a typical week of practice, compared with about 6% of medical and surgical specialists.

The study also found that the most frequent patient diagnoses in 2002 were for hypertension, the common cold, sore throat, diabetes and arthritis and joint disorders.

Drugs were prescribed at about two-thirds of visits totaling 1.3 billion drugs in 2002, a 25% increase in the utilization of medications over the past decade.

Contraception risk of STDs

Women who used the injectable contraceptive depot-medroxyprogesterone acetate, marketed under the name Depo Provera, had a greater risk of acquiring sexually transmitted diseases than women who did not use the hormonal contraceptive, according to a new study.

Researchers determined that women who used Depo Provera were 3.5 times more likely to develop either a chlamydial or gonococcal infection. The researchers also tested oral contraceptives containing both estrogen and progestin and concluded that oral contraceptives do not appear to significantly increase the risk of infections.

The study was unable to determine why the risk increased among Depo Provera users. "The findings underscore the need to counsel all sexually active women who use DMPA and who are not in mutually monogamous relationships to use condoms consistently and correctly," said study author Charles Morrison, PhD, senior epidemiologist at Family Health International in Research Triangle Park in North Carolina.

The 819 participants were recruited from a Baltimore city clinic, which served predominantly African-American people and a clinic in Towson, Md., which served predominantly white, college-age women.

The results appeared in the September Sexually Transmitted Diseases.

NIH releases strategy for obesity epidemic fight

The National Institutes of Health announced last month the details of its research strategy that it hopes will lead to useful tools in the battle against obesity and related diseases.

The agency intends to explore what factors are contributing to the United States' "obesogenic" environment and develop behavioral, societal, pharmacologic and surgical interventions that may turn the tide. The agency also wants to organize interdisciplinary research teams to link the behavioral, environmental, genetic and biological causes of obesity. The NIH intends to intensify efforts to break the link between obesity and diseases that can be worsened or caused by obesity such as diabetes, heart disease and some cancers and take a closer look at populations at high risk for obesity, such as ethnic minorities and older adults.