News in brief - Jan. 2/9, 2006

AMA proposes establishment of flu vaccine stockpile for small practices - Most not aware of health disparities - Pertussis guidelines updated - GI trouble may prevent overweight from exercising

AMA proposes establishment of flu vaccine stockpile for small practices

The American Medical Association has suggested that the Centers for Disease Control and Prevention establish an early-season inventory of the influenza vaccine that would be distributed to smaller medical practices, according to a statement published on the AMA's Web site last month.

This action comes in response to concerns many physicians, particularly those who use limited amounts of vaccine, might not have received sufficient supplies this season, while organizations that place significantly larger orders did.

The AMA also is moving up the National Influenza Vaccine Summit it organizes with the CDC from May to January to allow ample time to take action for next season. The two organizations are surveying physicians about their experiences this season, and the results are expected to be presented at the summit.

In related action, Sanofi Pasteur, one of the vaccine's manufacturers, announced it has produced more flu shots than expected. More than 58 million doses were shipped by the end of November, the company said. Another 3.5 million will be delivered to the CDC in January for a late-season stockpile. This means the company will deliver 12 million more doses than expected.

Another manufacturer, Chiron Corp., also distributed 11 million doses by the end of November. Another 4 million are expected by the end of December.

Most not aware of health disparities

A majority of Americans are unaware of the disparities that exist in health care, according to a new poll from the Harvard School of Public Health and the Robert Wood Johnson Foundation.

This lack of awareness was greatest among whites, with only 25% believing health care is worse for racial and ethnic minorities. In comparison, 44% of blacks and 56% of Hispanic Americans said racial and ethnic minorities received worse care than whites.

Although most Americans are unaware of the disparities in health care, they did respond that everyone deserves equal care.

"For more than 20 years, surveys have documented that racial and ethnic minorities receive a different level of care than whites," said Robert J. Blendon, ScD, director of the Harvard Program on Public Opinion and Health and Social Policy. "It is important for the public to be aware that disparities in health care exist, so the country can focus on solving this problem."

Pertussis guidelines updated

The Centers for Disease Control and Prevention has revised its guidelines for treating pertussis. The disease, despite an effective childhood vaccination, has continued to infect large numbers of people, mostly teens and young adults. There were 25,827 cases reported in 2004, the highest number since 1959, according to the agency.

The updated guidelines, published in the Dec. 9, 2005, Morbidity and Mortality Weekly Report, broaden the spectrum of antimicrobials to use when treating the disease.

The guidelines include dosing information for azithromycin and clarithromycin as well as the more standard erythromycin.

The CDC recommends continuing to vaccinate children ages 6 weeks to 6 years with diphtheria, tetanus toxoids and acellular pertussis vaccine, DTaP.

In addition, the agency's Advisory Committee on Immunization Practices voted last year to recommend a single dose of tetanus toxoid and reduced diphtheria and acellular pertussis vaccine, Tdap, for adolescents and adults younger than 65.

GI trouble may prevent overweight from exercising

Obesity increases the risk of abdominal pain and diarrhea, but physical activity appears to reduce these kinds of digestive problems, according to a study published in the October 2005 issue of Clinical Gastroenterology and Hepatology.

Researchers surveyed nearly a thousand patients participating in a study of interventions to promote weight loss about daily food intake, physical activity and gastrointestinal symptoms. A lack of physical activity most strongly correlated with an increased risk of digestive difficulties, and the authors suggest exercise might provide protection against trouble in this area.

This finding also might mean GI symptoms block those who are obese from getting the physical activity they need.

"It is plausible that if a physician put a patient on an exercise program to lose weight, the GI problems experienced might hamper the patient's ability to exercise," said Rona Levy, PhD, MPH, lead author and a professor of social work at the University of Washington in Seattle.