News in brief - July 25, 2005

New warning for adults taking antidepressants - CDC vaccine guide available - Defect in antioxidant response increases asthma susceptibility - Containing infectious disease is costly

New warning for adults taking antidepressants

The Food and Drug Administration issued a Public Health Advisory July 1 to boost warnings that adults taking antidepressants face a heightened risk of suicide. The warning was issued after several recent publications suggested there was increased risk, according to the agency.

Adults being treated with antidepressant medication, particularly those being treated for depression, should be watched closely for worsening depression and for increased thoughts of suicide or suicidal behavior, the FDA said.

Close monitoring could be especially important early in treatment or when the dose is either increased or decreased.

Although the advice is similar to that already on the labels of the antidepressants under review, the FDA intends to study the many hundreds of individual clinical trials of the medications involving thousands of adult patients. The study is expected to require a year or more to complete.

It will follow a similar process undertaken by the agency to determine the suicide risk for children who are prescribed antidepressants. That review resulted in black-box warnings about the link between the antidepressants and suicidal behavior in children. The drugs under review include Effexor, Paxil, Prozac, Zoloft and Wellbutrin.

CDC vaccine guide available

The Centers for Disease Control and Prevention posted on its Web site its 2005 guide, "Vaccine Management: Recommendations for Storage and Handling of Selected Biologics" (www.cdc.gov/nip/publications/vac_mgt_book.pdf).

The booklet covers storage requirements and shelf-life for vaccines, toxoids and immune globulins, including diphtheria/tetanus/pertussis and related toxoids; hepatitis vaccines; inactivated polio vaccine; influenza vaccines; measles, mumps and rubella vaccine; and meningococcal, pneumococcal and varicella vaccines.

The booklet includes advice on inspecting the materials when they arrive at the office and how best to reconstitute them if necessary as well as any special instructions required by each material.

Also provided are the vaccine manufacturers' quality control office phone numbers.

The booklet can be downloaded from the CDC's Web site.

Defect in antioxidant response increases asthma susceptibility

Disruption of the Nrf2 gene, which regulates the lungs' response to environmental pollution, increases the risk of severe inflammation and asthma, according to a study published in the July 4 Journal of Experimental Medicine.

Johns Hopkins University researchers studied allergen-mediated asthma in mouse models. When this gene was inhibited, the mice were more likely to get the disease. Researchers suggest that this may prove to become a new target for asthma therapy.

Researchers plan next to study the molecular mechanism for this gene's regulation.

Containing infectious disease is costly

Controlling a small measles outbreak in 2004 cost the Iowa Dept. of Public Health $142,452, and those costs would have soared even higher if the illness had been allowed to spread, according to a paper published in the July issue of Pediatrics.

Department officials analyzed the cost of tracing, treating and quarantining one unvaccinated student who returned from India with the disease, two others this person infected and the many people with whom they came into contact. Authors speculated that if measles had been allowed to spread, the cost could have increased to more than $700,000. This estimate does not take into account expenses incurred by the private health sector or individual loss of wages or productivity.

"Protecting the public from infectious disease has not only a personal health benefit, but an economic benefit to the community as well," said Patricia Quinlisk, one of the authors and Iowa state epidemiologist.

Authors advocate that economic analyses of vaccine-preventable diseases need to include not just the cost to the individual but also the cost to society.