News in brief - March 14, 2005

Study finds sleep test to be gold standard in detecting apnea - Hepatitis A vaccine reaching children at risk - Physicians urged to be aware of tularemia symptoms

Study finds sleep test to be gold standard in detecting apnea

An overnight sleep test was deemed the best way to distinguish ordinary snorers from those with obstructive sleep apnea, according to a study in the February Archives of Otolaryngology -- Head & Neck Surgery.

Although 30% to 50% of the general population snores, only 2% to 4% have sleep apnea, according to the article. The researchers evaluated 101 patients who snored. Medical histories and an assessment of the anatomy of four points in their noses and throats were used for the evaluations.

The patients were also examined using standard polysomnography, a measure of oxygen saturation and airflow, over the course of two nights.

"None of the reported medical history and/or anatomical parameters alone or in combination could be used to distinguish patients with OSA from snoring patients," the authors wrote.

Hepatitis A vaccine reaching children at risk

Just more than half of children residing in states where vaccination against hepatitis A is routinely recommended and a quarter of those living in states where it is recommended for consideration have received at least one shot protecting against the illness, according to a paper in the Feb. 18 Morbidity and Mortality Weekly Report. Just over 1% of children in areas without a specific recommendation have also received the vaccine.

Researchers analyzed data from the National Immunization Survey finding that hepatitis A vaccination rates were generally lower than that of other recommended vaccines.

Authors of the report concluded that programs are reaching those who need the vaccine the most but are not going far enough. The CDC recommended in 1999 a two-dose regimen for all children living in areas with a high hepatitis A prevalence. Consideration was also recommended for areas with a moderate prevalence.

Physicians urged to be aware of tularemia symptoms

In the wake of an increasing number of human cases of tularemia linked to epidemics of the disease in rabbits, public health officials are calling on physicians to be familiar with the symptoms and related local epidemiology, according to the Feb. 25 issue of Morbidity and Mortality Weekly Report.

Officials with the Wyoming Dept. of Health investigated an increase in human cases in that state from 2001 to 2003 and compared them to those occurring in the decade earlier. Ten cases were reported from 1990 to 2000, but 11 were reported from 2001 to 2003. Also, most of the more recent cases were linked to insect bites rather than exposure to ticks, rabbits or sheep, which caused most of the cases in the 1990s.

The CDC notes that symptoms vary, depending on the route of exposure, but can include skin ulcers, swollen and painful lymph glands, inflamed eyes, sore throat, mouth sores, diarrhea, pneumonia, fever, chills, headache, muscle aches, joint pain, dry cough and progressive weakness.

The authors of this paper are linking the human outbreak to a rabbit outbreak noted simultaneously at Wyoming's Seedskadee National Wildlife Refuge.