November 18

Immunizing children called better way to fight flu

first_img Besides the mathematical model studies, the writers cite several other pieces of evidence in support of the strategy. For example, in 1968, vaccination of 85% of schoolchildren in Tecumseh, Mich., led to a 67% lower rate of flu-like illness than was seen in a neighboring town. And in Japan, a policy of vaccinating schoolchildren against flu prevented an estimated 37,000 to 49,000 deaths per year from 1962 to 1987. “If the 70 percent threshold can be reached, then high-risk people are protected even if they are not vaccinated,” the authors assert. “Since there are about 60 million schoolchildren in the United States, about 42 million doses of vaccine would be needed to get below the epidemic threshold. Thus, even this year we would have had enough vaccine to reduce transmission in the entire country by concentrating on schoolchildren.” Feb 22, 2005 (CIDRAP News) – The idea that vaccinating schoolchildren is the best way to prevent influenza throughout the US population received a boost last week with the publication of a commentary and a Texas study in separate journals. Longini and Halloran say they don’t know why the United States has never tried the approach they advocate. But they write that until the past few years, public health officials have focused on the direct protection provided by immunization and have not taken the potential indirect effects seriously. Since schoolchildren are not considered a high-risk group, they have been left out of the recommendations. Piedra PA, Gaglani MJ, Kozinetz CA, et al. Herd immunity in adults against influenza-related illnesses with use of the trivalent live attenuated influenza vaccine (CAIV-T) in children. Vaccine 2005;23(13):1540-8 [Abstract] In the following three seasons, children aged 1.5 to 18 years in the intervention communities were targeted for immunization with live-virus intranasal flu vaccine. Between 20% and 25% of the age-eligible children in the two communities were immunized. The commentary making the case for flu shots in children is offered by Ira M. Longini Jr. and M. Elizabeth Halloran in the American Journal of Epidemiology. They write that the existing flu vaccination strategy has had only a small effect on overall flu morbidity and mortality, though vaccination has an important effect on mortality in elderly people. The researchers found that illness rates in adults older than 35 in the intervention cities were reduced by 8%, 18%, and 15% in the first, second, and third years of the program, relative to the same age-group in the comparison cities. All the reductions were significant. No consistent drop in respiratory illness rates was seen in younger groups. The Baylor study was reported by Pedro A. Piedra and colleagues in Vaccine. They monitored respiratory illness rates among members of one health plan in two communities where children were targeted for vaccination and in three other communities where the usual immunization strategy was used. Baseline rates of medically attended respiratory illness, measured in the 1997-98 season, were about the same in the intervention and comparison communities. According to Longini and Halloran, several previously published reports based on mathematical models of flu epidemics predict that vaccinating 70% of children would keep the illness from reaching epidemic levels. The models indicate that vaccinating even 50% of schoolchildren would considerably reduce flu in the general population. In the commentary, two biostatisticians from Emory University in Atlanta argue that the current strategy of targeting high-risk groups has had little effect on the spread of flu and relatively little effect on flu illness and death rates. The authors say a better strategy would be to vaccinate at least 70% of schoolchildren, who are the major spreaders of flu in the general population. See also: The current CDC strategy stresses flu immunization for groups at highest risk for serious complications of flu, including the elderly, children aged 6 to 23 months, people with chronic illness, pregnant women, healthcare workers, and children on chronic aspirin therapy. The authors calculated that the program eliminated a total of 1,071 medical visits in the two cities over the 3 years. In the Texas study, researchers from Baylor College of Medicine in Houston report that vaccinating about 25% of children in two communities led to significant reductions in flu rates among adults older than 35, relative to three other cities where a conventional flu immunization strategy was used. Longini IM Jr, Halloran ME. Strategy for distribution of influenza vaccine to high-risk groups and children. Am J Epidemiol 2005;161(4):303-6 [Abstract] The authors advocate continuing to immunize high-risk groups at the current level while focusing on using the rest of the vaccine supply on schoolchildren (ages 5 to 18). That approach would provide some direct protection for high-risk people “while greatly curtailing the spread of influenza in the rest of the population by concentrating vaccine in the group most responsible for community-wide transmission.” The two articles came out the same week that researchers from the National Institutes of Health reported that the increasing flu immunization coverage of elderly people in recent decades has had no detectable impact on flu-related death rates among the elderly. That report prompted the Centers for Disease Control and Prevention (CDC) to issue a statement saying it is still important for older people to get flu shots. Feb 16 CIDRAP News story “Study: Flu shots in elderly don’t cut mortality rate”last_img read more

September 18

Serena Williams to play Sharapova in US Open first round

first_imgSERENA Williams will play Maria Sharapova in the first round of the US Open at Flushing Meadows in New York.Britain’s Johanna Konta faces Daria Kasatkina of Russia while Kyle Edmund will play Spain’s Pablo Andujar.Dan Evans faces Adrian Mannarino of France while Cameron Norrie will take on a qualifier.Novak Djokovic begins his title defence against Spaniard Roberto Carballes Baena while 2018 women’s champion Naomi Osaka plays Anna Blinkova of Russia.Elsewhere in the men’s draw, Spain’s Rafael Nadal will play Australian John Millman while 20-time Grand Slam champion Roger Federer will face a qualifier.In the women’s draw, 15-year-old Coco Gauff, who beat Venus Williams on her way to reaching the fourth round at Wimbledon last month, will play Russia’s Anastasia Potapova. Meanwhile, Wimbledon champion Simona Halep will take on a qualifier. (BBC Sport)last_img read more

August 12

Steelers hear ‘the voice’

first_imgby Barry WilnerAP Pro Football Writer LATROBE, Pa. (AP)—Jerricho Cotchery hears “the voice.” Troy Polamalu senses the “phantom leadership.”It’s all part of the Steelers Way.Few organizations boast the stability and winning tradition of the Steelers. Try just three coaches in 43 years. Try the same family in charge—the Rooneys. It’s gone from the Chief, Art Rooney, to his son Dan, to his grandson, Art II, the current team president.In the Super Bowl era, they have gone home with the Lombardi Trophy a record six times in eight appearances. If you want consistency on and off the field in the NFL, look at Pittsburgh.Yet, there is a sense of transition in the Steel City this year. Gone are some key leaders, particularly all-time leading receiver Hines Ward, now retired, and stalwart linebacker James Farrior. The powerful running game that for years— decades—was emblematic of the Steelers’ offense could be in disarray.There also seems to be transition within the AFC North that Pittsburgh has owned pretty much since the NFL went to its current format in 2002. Baltimore edged the Steelers for the division title last year and is considered the favorite to repeat. Cincinnati is regarded as a team on the rise. And there are many questions surrounding these Steelers.Not to worry, star safety Polamalu says.“You could say there is a transition after every season because the team won’t be exactly the same from year to year,” says the 2010 Defensive Player of the Year. “But I would answer the same way as I did the last nine years: The new challenge is exciting. I think it will be an exciting season. It’s going to be exciting to see how the players fit in, especially in the secondary, and how healthy we are.“You either survive and you push on, or you adjust the best you can.”The Steelers (No. 7 in the AP Pro32) have an edge in making the adjustments, too.“What’s also unique is what I would call the ‘phantom leadership’ that is in the tradition of the Steelers,” he adds with a smile. “It’s the way we do things around here and the way they have always done things, a certain way that works. It dates back to Joe Greene and those days. It’s something that is real.“So there’s that tradition that we have that sort of ‘phantom leadership’ out of the past.“We don’t need the rah-rah guy or the guy who is the ‘face of the franchise.’ We’re not pushing people to be out front. Be yourself, lead in your own way.”Leadership rarely has been an issue in the Steel City. And it might not be now with Polamalu, James Harrison, Ike Taylor, Ryan Clark, Ben Roethlisberger and Heath Miller still around. Just the fact it is being mentioned, though, is different.Although Pittsburgh went 12-4 last season, when neither Ward, Farrior nor now-retired defensive end Aaron Smith made much impact, it was not an impressive 12-4, if you can imagine that. The Steelers looked old, slow and not especially resourceful in their wild-card loss to Denver in the playoffs.Seven months later, Roethlisberger—as much a key to these Steelers as Terry Bradshaw was in the latter years of the Steel Curtain dynasty of the 1970s—is banged up (left ankle, rotator cuff). They are searching for a running game with starting tailback Rashard Mendenhall healing from a severe knee injury, and need to discover some continuity on the offensive line.And with deep threat Mike Wallace holding out, the receiving corps is missing an important element, although it remains a strength with Antonio Brown, Emmanuel Sanders, Miller and Cotchery.Plus, the defense probably will have seven starters over 30: Polamalu, Taylor, Clark, Harrison, Brett Keisel, Larry Foote and Casey Hampton.Despite all those questions, the one topic that doesn’t seem to concern anyone is a loss of leadership.“We’ve been through this before,” 10th-year cornerback Taylor says. “When Joey Porter left, James Farrior stepped in. Our team never is without leaders.”Or voices in the locker room.“What I learned from the older guys when I got here was you have got to pass it on,” Foote adds. “Leadership is something I’’ve learned from being in the league for 11 years, and that there are all kinds of (leaders). There were a lot of personalities on this team, guys who have been here the last decade, and now they are gone. So others step up. It’s a changing of the guard.”Change can be good in pro football, even for a franchise so steeped in tradition; some might say so set in its ways. Rarely have the Steelers been potentially so dynamic in the passing game, and certainly not since Bradshaw, Lynn Swann and John Stallworth left.They tend to excel at developing their draft choices, with Roethlisberger, Polamalu, Miller and Hampton prime examples. Brown and young center Maurkice Pouncey are following that trend.Several important pieces are in their prime, including linebacker LaMarr Woodley, possibly their most dynamic defender, and Roethlisberger.Cotchery, an outsider who joined the Steelers last year as a free agent, was drawn to Pittsburgh not only by what he saw on the roster, but by something a bit more nebulous.The voice.“This organization is unique,” says Cotchery, who was with the Jets before heading to Pittsburgh. “It has a certain way of doing things over a long period that works, and they stick to it. And the result: six Super Bowls. And working on more.“I appreciate the tradition and the history of this organization and the way they have carried themselves. That drew me to the organization; they are loyal to their guys.“To me, the voice is kept here. No one else comes in with a different voice and no one talks over this voice. It’s the Steelers voice.”last_img read more