Vaccinations in Ky. keep slowing; FEMA to open sites in London, Henderson next week; one-dose vaccine likely to return soon

The Johnson & Johnson vaccine carries the Janssen
brand name. (New York Times photo by Bryan Anselm)

By Al Cross
Kentucky Health News

Kentucky continued to make slow progress against the coronavirus Friday, as most measures of the pandemic declined slightly and the number of Kentuckians who have received at least one dose of vaccine passed 1.7 million.

But only 11,088 vaccinations were added to the total, less than last week's daily average of 12,138, which includes weekends. The state announced that the Federal Emergency Management Agency will open vaccination sites in Henderson and London that can each vaccinate 1,000 people per day.

“It is getting easier and easier for Kentuckians to get their shot of hope,” Gov. Andy Beshear said in a press release. “With this extra help from the federal government, the opportunities are even greater. Now is the time for us all to step up to end this battle with the coronavirus once and for all. Talk to people you trust to get the information you need about the vaccines, find a location near you and get vaccinated. We can do this, Kentucky.”

Vaccination sites are listed at vaccinemap.ky.gov.

In another release, Beshear announced that 1,708,318 Kentuckians had received at least their first dose of a vaccine. “Now, fewer than 800,000 Kentuckians 16 and older need to sign up to receive their shot of hope in order for us to reach our goal and lift a lot more restrictions.” Beshear has said that when 2.5 million people have been vaccinated, he will remove capacity limits on businesses and events of fewer than 1,000 people.

The New York Times data tracker says 29 percent of Kentuckians are fully vaccinated, a rank that is 19th among the states. In the South, it is tops in full vaccination and second only to Virginia in one-dose vaccination, according to the Centers for Disease Control and Prevention.

Demand for vaccines was already exceeding supply before April 13, when use of the more recently released one-dose Johnson & Johnson vaccine was suspended after a rare type of blood clot was found in six women out of more than 7 million people who had received it. All were of child-bearing age.

Friday, a CDC advisory committee voted 10-4 to recommended that use of the vaccine be resumed, with a warning label for women under 50. The CDC and the Food and Drug Administration are likely to approve the recommendation, as early as this weekend.

Resuming use of the one-dose vaccine appears likely to boost vaccination efforts. Beshear and health officials have said many people want to get their immunity with one dose of vaccine.

The suspension has complicated outreach to "the homebound, the homeless, the hesitant and those who have trouble accessing vaccines," The Washington Post reports. "It is also forcing some health care providers to switch to the more cumbersome Moderna and Pfizer-BioNTech products, which require two doses, are harder to transport and need to be stored at ultracold temperatures."

Meanwhile, "Senior health officials frustrated by Johnson & Johnson’s repeated vaccine stumbles are no longer counting on the company to play a major role in the broader effort to inoculate the nation against coronavirus, Politico reports. "The flagging confidence comes in the wake of a series of setbacks that included a mix-up at one of J&J’s vaccine manufacturing contractors that ruined 15 million doses and revealed serious safety and hygiene lapses."

The state did not say which vaccine(s) will be offered at the Community Vaccination Centers that will open Wednesday at 200 County Extension Rd. in London and Thursday at 3341 Zion Rd. in Henderson. 

The sites will have their own vaccine supply in addition to the regular allocations the state gets. "These additional vaccine doses are made possible through an increase in production and availability," Beshear's release said. "FEMA and the commonwealth will continue reaching out to underserved communities in Kentucky to inform and build trust about the benefits of getting vaccinated."

 

The sites will vaccinate both registered and walk-up visitors. After getting their jab, the vaccinated will go to a post-vaccine waiting area for at least 15 minutes to be monitored for any adverse reactions.

Daily numbers: The state reported 607 new coronavirus cases, lowering the seven-day rolling average by 16, to 533. In the last eight months, only two days, April 8 and April 10, have had lower seven-day averages.

The seven-day statewide average of new cases declined for the sixth day in a row, to 10.57 per 100,000. The New York Times ranks Kentucky's rate 35th among the states.

Counties with rates more than double the statewide rate are Lewis, 48.4; Powell, 42.8; Bath, 42.3; Morgan, 37.6; Mason, 33.5; Robertson, 27.1; Wolfe, 25.9; Montgomery, 25.9; Bracken, 25.8; Simpson, 23.1; Hancock, 22.9; and Logan, 22.7.

The percentage of Kentuckians testing positive for the virus declined for the fifth day in a row, to 3.26%, about where it was 10 days earlier.

The state added 22 fatalities to its list of Covid-19 deaths, five from regular health-department reports and 17 from the ongoing audit of death certificates.

The regularly reported deaths were all in April of March, except a 77-year-old Johnson County man who died Nov. 14. The others were a Fayette County woman, 106; a Gallatin County woman, 74; a Jefferson County man, 81; and a Simpson County woman, 102.

The audit deaths, all from Nov. 15 to Jan. 19, were a Bell County man, 72; a Breckinridge County woman, 58; a Bullitt County man, 79; a Calloway County man, 80; a Garrard County man, 79; two Hardin County women, 69 and 70; two Jefferson County women, 87 and 90; two Jefferson County man, 73 and 88; a Jessamine County man, 77; a Kenton County woman, 80; an Owsley County woman, 80; an Owsley County man, 78; a Spencer County woman, 81; and a Warren County woman, 77.

In other pandemic news Friday:

• Counties with more than 10 new cases were Jefferson, 110; Fayette, 54; Kenton, 28; Warren, 21; Boone, 19; Laurel, 13; Bath, Christian, Henderson, Mason and Pike, 12; Daviess, Lewis, Montgomery and Powell, 11; and Barren, Hardin and McCracken, 10.
• Kentucky hospitals reported 420 Covid-19 patients, 20 fewer than Thursday; 113 of them in intensive care, down 7; and 50 on a ventilator, down 5. 

First Kentuckian gets Caribbean virus, chikungunya or CHIK-V

State officials have confirmed Kentucky's first case of the Caribbean virus chikungunya—or CHIK-V. The first case is an Anderson County man who recently went to Haiti. Though CHIK-V is not native to Kentucky and doesn't usually result in death, officials encourage those who have recently visited the Caribbean and who may be experiencing symptoms to visit the doctor to make sure they don't have the disease, Josh James reports for WUKY-FM.

The mosquito-borne disease occurs most often in Africa, East Asia and the Caribbean islands, but the federal Centers for Disease Control has been observing the spread of the virus hoping that it won't become a significant issue in the United States like the West Nile did more than 10 years ago, Val Willingham reports for CNN. Several weeks ago, the number of cases in the Caribbean exceeded 170,000, and the number of deaths from the disease was 14, Lisa Schnirring reports for Center for Infectious Disease Research and Policy. 

The disease can cause joint pain and arthritis-like symptoms, and those with weak immune systems are especially at risk for worse symptoms. The disease is transmitted from mosquito to human and from human to mosquito. Though about 25 to 28 travelers bring CHIK-V to the U.S. every year, "We haven't had any locally transmitted cases in the U.S. thus far," said Roger Nasci, chief of the CDC's Arboviral Disease Branch in the Division of Vector-Borne Diseases.

"Someone would have to be bitten by an infected insect to become ill. Person to person contact does not spread the disease," Kevin Hall of the Lexington-Fayette County Health Department said, James writes. However, it's worth noting that Kentucky is "home to both species of mosquito known to carry the virus," James reports.

Prescribing antibiotics for viral infections must stop; overuse of antibiotics causes antibiotic-resistant 'superbugs'

Bronchitis is a viral infection, and antibiotics are not effective for treating viral infections.

Doctors know this, yet they continue to prescribe antibiotics to patients with bronchitis and other viral infections anyway, Ezra Klein reports on his new website, Vox.

Research shows that doctors prescribe antibiotics for acute bronchitis about 71 percent of the time even though they know that overuse of antibiotics is the leading cause of "superbugs," or organisms that are resistant to some if not all antibiotics, Klein reports. They do this because it makes patients feel better to walk out of the doctor's office with a treatment.

Klein goes on to paint a picture of a post-antibiotic future that could result from doctors prescribing antibiotics for viral infections. Klein reports that  patients must stop thinking that good physician care is the result of being treated with an antibiotic, especially in the treatment of bronchitis.

Kentucky and its Southern neighbors overuse more than their share of antibiotics.  The southeastern states are the highest users of antibiotics, with twice as many antibiotic prescriptions as states in the Pacific region, according to a study by the Center for Disease Dynamics, Economics & Policy, part of the federal Centers for Disease Control and Prevention.

CDC recommends that every hospital in this country have an antibiotic stewardship program and track their resistance and prescribing patterns. Half of all hospital patients get antibiotics and one-third of the antibiotics prescribed are inappropriate or are unnecessary, CDC Director Tom Frieden told Klein.

Frieden said the world is at risk of losing antibiotics to resistance created by over-prescribing, but a "modest investment" can thwart the most dangerous drug-resistant organisms. Working toward creating new antibiotics and then not falling into the same patterns of abuse must also be part of the solution, Frieden said. (Read more)

New research argues that Alzheimer's disease should rank as third most common cause of death in the U.S.

Alzheimer's disease may contribute to almost as many deaths in the U.S. as heart disease or cancer, says a recent study published in Neurology.

Alzheimer's is listed as the nation's sixth leading cause of death, far behind the leading causes of death, heart disease and cancer, according to the federal Centers for Disease Control and Prevention. But the study says it should rank third.

Because death certificates provide the information used for these statistics, the overall picture of what causes death is often not told, especially in the elderly. This creates a system of under-reporting the complete reason for the death, lead author of the study Bryan D. James of Rush University Medical Center in Chicago said in Newswise, a research-reporting service.

“The estimates generated by our analysis suggest that deaths from Alzheimer’s disease far exceed the numbers reported by the CDC and those listed on death certificates,”James said.

The study supports contentions of the Alzheimer's Association, which estimates that the disease causes about a third of the deaths in Kentucky. In 2010, 8 percent of Kentuckians age 65 and older, or 80,000, had Alzheimer's, with a projected number of 97,000 in 2025.

The study did annual testing for dementia on 2,566 people ages 65 and older. It found that 559 participants without dementia at the start of the study developed Alzheimer’s. Within eight years of the study, 1,090 participants died. Those diagnosed with Alzheimer's between ages 75 to 84 had a death rate more than four times higher after the diagnosis and people 85 and older nearly three times higher than the whole.

Researchers concluded that More than one-third of all deaths in those 75 and older were caused by Alzheimer's, and that an estimated 503,400 Americans over age 75 in 2010 died from it. That's five to six times higher than the 83,494 number reported by the CDC. That would move the disease from the sixth leading cause of death and to the third; chronic lung disease, stroke and accidents now rank third, fourth and fifth.

First diabetes educator license is issued in Kentucky

Kim DeCoste (photo via AADE)

Kentucky is the first state to issue a diabetes educator license, according to a press release from the Kentucky Board of Licensed Diabetes Educators.

Kim DeCoste of Richmond, a registered nurse and chair of the Kentucky Diabetes Educators Licensure Board, is the licensee.

"I am proud to represent diabetes educators throughout Kentucky as the first person to receive a license,” DeCoste said. “Kentucky’s legislation assures that the qualifications of diabetes educators have been thoroughly reviewed and that individuals are appropriately credentialed. Improved consumer safety is vital as diabetes care becomes increasingly complex.”

The release said Kentucky passed laws in 2011 to require licensing of diabetes educators in an effort to improve the quality of health care in the state, which has a high rate of diabetes. Ten percent of Kentucky adults, or approximately 370,000, had been diagnosed with diabetes in 2010, according to the latest Kentucky Diabetes Report. An additional 233,000 Kentucky adults have been diagnosed with pre-diabetes, and research from the federal Centers for Disease Control and Prevention has indicated that approximately 27 percent of people with diabetes have not been tested or diagnosed.

Because diabetes is controllable if diagnosed early and managed well, diabetes educators play a vital role in working with people who have or are at risk of developing diabetes and developing a plan of care, the report says.

The American Association of Diabetes Educators define a diabetes educator as “health care professionals—registered nurses, registered dietitians and pharmacists, among others—who specialize in helping people with diabetes understand how to best manage their health.”

Great American Smokeout is Thursday, Nov. 21, featuring supportive characters to share on social media and a Twitter chat

The American Cancer Society's annual Great American Smokeout will be held Thursday, Nov. 21. The event encourages smokers to quit smoking, or make a plan to quit smoking, that day.

Quitting, even for one day, according to the Cancer Society, is an important step toward a healthier life, one that can lead to reducing cancer risk.

In Kentucky, according to the Centers for Disease Control and Prevention, 25.2 percent of adults are cigarette smokers, second highest in the nation. The Kentucky Tobacco and Cessation Program reports that each year more than 8,000 Kentuckians die of illnesses caused by tobacco use.

"Tobacco use remains the single largest preventable cause of disease and premature death in the U.S., yet nearly one in every five adults smoke," the Cancer Society says. It also notes that there are 13.2 million cigar smokers in the U.S. and 2.2 million who smoke tobacco in pipes, which are also dangerous and addictive forms of tobacco.

To celebrate quitters and their supporters, the American Cancer Society has designed a series of characters available to share on social networks. (See characters.)

They are also hosting, with Sharecare, a Great American Smokeout Twitter Chat on Wed., Nov. 20. This event allows you to post questions on Twitter to  @Sharecarenow  about how to quit smoking, smoking legislation or anything on your mind related to smoking.  You can also submit questions on Sharecare’s Facebook page.  The answers from the Cancer Society and other experts will roll out on Twitter at #quitforgood on Thurs., Nov. 21, between 11 a.m. and 4 p.m.

The health benefits of quitting are greater if you quit when you are young, but quitting at any age is beneficial. The Cancer Society lists the benefits chronologically:

• In 20 minutes: your heart rate and blood pressure drop
• In 12 hours: the carbon monoxide level in your blood drops to normal
• 2 weeks to 3 months: your circulation improves and your lung function increases
• 1-9 months: coughing and shortness of breath decrease
• 1 year: your risk of coronary heart disease is cut to half that of a continuing smoker
• 5 years: risk of certain cancers is cut in half, and stroke risk can fall to that of a non-smoker
• 10 years: the risk of dying from lung cancer is about half that of a person who still smokes and other cancer risk decrease
• 15 years: the risk of coronary heart disease is that of a non-smoker

The American Cancer Society is available to offer steps to quit smoking and to provide quit-smoking programs. To learn about the available tools, call 1-800-227-2345.

Some schools let kids with live head lice stay; policy change has some Kentucky parents scratching their heads

By Molly Burchett
Kentucky Health News

School districts across the country are adopting policies that say students diagnosed with live head lice or nits (louse eggs) can remain in school and parents don't need to be alerted when their child comes in contact with lice. Others schools say they will keep strict lice policies and will continue to alert parents about lice infestations. What's the policy at your child's school?

The American Pediatric Association, the Harvard School of Public Health and the National Association of School Nurses recommend that schools discontinue "no-nits" policies, taking the position that students should not be excluded from school due to suspected head lice or due to nits only. The Kentucky Department of Education and the Kentucky School Board Association also support this recommendation.

The organizations say "no-nit" policies that require a child to be free of nits before they can return to schools should be discontinued because nits are very unlikely to hatch and become crawling lice, nits are cemented to hair shafts and are unlikely to be transferred to another person, and the burden of absenteeism to the students and communities isn't doesn't outweigh the risks of head lice.

This policy shift is designed to help keep children from missing class and to shield children with lice from embarrassment, but these more lenient policies are bugging some parents, reports Jennifer Kerr of The Associated Press.

One school in Paducah says its strict policy about alerting parents if their child gets lice won't change anytime soon, reports Mychaela Brunen of WPSD-TV.

Vicki Brantner has been a school nurse at McNabb Elementary School in Paducah for six years and says the school's strict lice policy is here to stay. "When we have somebody that has head lice, we have a step-by-step procedure that we give to them to take home, it's not only washing the hair, but you have to clean your environment," Brantner told Brunen.

"We have a no-nit policy which means not only can they be here if they have the actual bug, but all the eggs removed also," said Brantner. She said parents with elementary school-aged kids should check their child's hair for lice once a week.

Marcey Davis, a mother of five, said she appreciates getting notices about lice infestations from McNabb Elementary. "It keeps me informed as a parent, as to what's going on in their classrooms and the school," she told Buren. "Parents need to stay on top of in order to keep a lice-free school, at the risk of embarrassing my child, I would rather know about it."

The head louse is a parasitic insect that can be found on the head, eyebrows, and eyelashes of people, and the CDC estimates that 6 million to 12 million infestations occur each year between schoolchildren between the ages of 3 and 11. It is much more common for schoolchildren to get lice because schools bring large numbers of children together where they are in close contact with each other, reports Mike Potter of the University of Kentucky College of Agriculture.

Here are some tips from the CDC that can be used to prevent and control the spread of lice:

• Avoid head-to-head (hair-to-hair) contact during play and other activities at home, school, and elsewhere (sports activities, playground, slumber parties, camp). 
• Do not share clothing such as hats, scarves, coats, sports uniforms, hair ribbons, or barrettes.
• Do not share combs, brushes, or towels. Disinfest combs and brushes used by an infested person by soaking them in hot water (at least 130°F) for 5–10 minutes. 
• Do not lie on beds, couches, pillows, carpets, or stuffed animals that have recently been in contact with an infested person.

Increased contact with bats leads to more rabies vaccinations in N. Ky.; health officials say all encounters should be reported

Fruit bat roosting in a home

Northern Kentucky health officials are warning residents to be more wary of bats after an unusually high number of residents have made contact with bats inside their homes and have had to receive the rabies vaccine. They are asking them to report any encounter with bats to the health department.

Bats are commonly infected with rabies and have very small teeth, and so someone who wakes up with a bat in their bedroom might not realize it has bitten them, Northern Kentucky Health Department spokeswoman Emily Gresham-Werle told Brenna Kelly of The Kentucky Inquirer.

It is crucial to vaccinate against rabies after contact with a bat, if the bat cannot be captured to receive testing for rabies. "If someone is exposed to the rabies virus and not treated, the result is neurological disease and death," Kelly notes.

Each year, tens of thousands of people are successfully protected from developing rabies through vaccination after being bitten by an animal like a bat that may have rabies, says the Center for Disease Control and Prevention. "There are usually only one or two human rabies cases each year in the United States, and the most common way for people to get rabies in the United States is through contact with a bat," says the CDC. Some of these reported cases resulted from known encounters with bats.

The problem In Northern Kentucky may be due to development in the area that has caused bats to lose their natural habitat. So far this year, 13 people who were exposed to bats have decided to get the vaccine. Usually only two to three people a year in the area have to get the vaccine because of a bat, Gresham-Wherle said. "Local and state health officials speculate that the weather and loss of bat habitat have contributed to the high number," reports Kelly.

"The rabies vaccine, which is nearly 100 percent effective against the virus, involves four rabies shots and one antibody shot over a period of two weeks. The vaccine, which is given by shots in the arm, can also be expensive, with costs ranging from $2,000 to $6,000 for the series, with additional fees for doctors or emergency room visits," Gresham-Werle told Kelly.

All exposure to bats and all bites by mammals must be reported to the local health department. In some instances the animal may be captured for rabies testing so that the bitten individual will not need to be vaccinated against the deadly disease. You can't tell if an animal carries the rabies virus just by looking at it, because rabies can only be confirmed in a laboratory, warns the CDC.

Does gum disease indicate future joint problems? Study links gum-disease bacterium to collagen-caused rheumatoid arthritis

Although researchers and clinicians have long known about an association between two prevalent chronic inflammatory diseases - periodontal disease and rheumatoid arthritis - the microbiological links have been unclear; a new study suggests this link is causative and that the bacteria responsible for gum disease leads to a faster progression of rheumatoid arthritis.

In a recent article published in PLoS Pathogens by University of Louisville School of Dentistry researchers say, "The bacterium responsible for periodontal disease, Porphyromonas gingivalis, worsens rheumatoid athritis by leading to earlier onset, faster progression and greater severity of the disease, including increased bone and cartilage destruction," according to a U of L news release.

The study says the bacterium produces an enzyme that worsens collagen-induced arthritis, a form of arthritis similar to rheumatoid arthritis produced in the laboratory.

The study was led by Oral Health and Systemic Diseases Group researcher Dr. Jan Potempa and a team that also studied another oral bacterium for the same effect, and found it did not affect collagen-induced arthritis or suggest a link to rheumatoid arthritis.

“This ground-breaking conclusion will need to be verified with further research,” said Potempa. Although the specific cause for the disease remains unknown, Potempa said he hopes these findings will shed new light on the treatment and prevention of rheumatoid arthritis.

An estimated 294,000 children under age 18 have some form of arthritis or rheumatic condition, says 2010 data from the Center for Disease Control and Prevention; this represents approximately 1 in every 250 children in the U.S. An estimated 1.5 million adults had rheumatoid arthritis in 2007. Click here for more information from the CDC.

Hard-hitting TV ads against smoking do motivate smokers, like one mother from Elizabethtown, to quit

Hancock with CDC Director Tom Frieden

A 38-year-old Elizabethtown mother's response to a federally funded anti-smoking advertising campaign has been featured in national news this week, showing that these graphic ads can motivate smokers to quit.

Lisha Hancock's decision to stop her two-decade smoking habit was sparked by her viewing of a Centers for Disease Control and Prevention’s “Tips from Former Smokers” campaign commercial, reports Sarah Bennett of The News-Enterprise in Elizabethtown.

Hancock's husband often urged her to quit, and several of her relatives died from smoking, but she still didn't quit. She continuously had a sore throat and clogged sinuses, but she still didn't quit. Then, she saw the commercial.

The advertisement featured raw images of Terrie Hall, a North Carolina woman who was diagnosed with throat and oral cancers at age 40, getting ready in the morning by putting on a wig, artificial teeth an an artificial voice box inside a small hole in her neck, since throat cancer forced her to have her larynx removed.

TV spokeswoman Terrie Hall with grandson's picture

"The only voice my grandson’s ever heard is this one,” Hall says in a robot-like voice, displaying his picture. UPDATE: Hall died Sept. 16.

The ad made a lasting impression on Hancock, who told Bennett she decided to quit smoking after watching the ad with her son: “One time my son asked me, ‘Mom, why does her voice sound like that?’ I said, ‘Because she smoked.’ Then he asked, ‘So you’ll sound like that?’”

Hancock said she had tried to quit before, but "There's nothing that touched me like Terrie's ad. It definitely impacted my life and, in return, impacted my family's life. We all live happier and healthier now."

Hancock started to quit eight months ago. Using nicotine lozenges and a combination of exercise and healthful eating, she's been able to go without even one cigarette, reports Anahad O'Conner of The New York Times.

Others have also been struck by this hard-hitting campaign, which may have prompted more than 100,000 Americans to quit smoking permanently, says a new CDC study published in The Lancet, the leading British medical journal. The CDC says an estimated 1.6 million U.S. smokers attempted to quit this past year after viewing campaign materials funded by the Affordable Care Act.

"Hard-hitting ads work," said CDC Director Dr. Tom Frieden. The agency paid approximately $50 million to produce and place the spots, the first time the federal government funded a nationwide tobacco-education ad campaign, reports Jonathan Serrie of Fox News.

"The impact is huge because a smoker costs about $2,000 more [per year] than a non-smoker, and about $1,000 more than an ex-smoker, to care for," Frieden said. "And if you do the math, this program pays for itself in a year or two in reduced health-care and societal expenditures."

The campaign also saved an estimated 300,000 years of life that smoking-related diseases would have taken, reports Brady Dennis of The Washington Post. Smoking remains the leading cause of preventable death in the United States, killing more than 1,200 Americans each day, says the CDC.

Click here for the CDC ads and other smoking-cessation resources.

Prescription drugs killing more women than ever; Kentucky ties for fifth for its high percentage of deaths

The ongoing national epidemic of addiction to prescription painkillers is spreading more quickly among women, and it is killing more women than ever before. Kentucky ties Utah for the fifth highest percentage of female deaths due to prescription-drug overdose (15.7 percent), says a new government report.

Opioids, or prescription painkillers, are the leading cause of drug-overdose deaths among women, accounting for 70 percent of overdoses. And, although men are more likely than women to die from drug overdose and Kentucky has the highest rate of male deaths in the country (25.9 percent), the percentage increase in the rate of overdose deaths from 1999 to 2010 was greater for women (151 percent) than for men (85 percent). During that period, there was a 415 percent overall increase in opioid painkiller-related deaths among women, compared with a 265 percent increase among men, says a Centers for Disease Control Vital Signs report released last week. (CDC graphics)

Since 2007, more women have died from drug overdoses than from motor-vehicle traffic injuries and about five times as many women died from prescription-painkiller overdoses in 2010 as in 1999. About 6,600 of those deaths occurred in 2010 alone, and prescription painkillers are reported to be involved in one of every 10 suicides among women, says the report.

Across the nation, about 18 women per day die from prescription drug overdose and every three minutes, a women goes to an emergency room for prescription-painkiller misuse or abuse, which is more likely to occur in women between the ages of 25 and 54. The report also says the rise of deaths from prescription drugs relates closely to increased prescribing of these drugs during the past decade.

States can take action against the dangers of prescription drug abuse by increasing access to substance abuse treatment while reducing barriers to getting such treatment, says the report. It is also important to educate health care providers about effective pain treatment options and to educate the public about the risks and benefits of taking prescription painkillers. Click here for a PDF factsheet from the CDC.

At least one in eight teens, and perhaps one in five, have a mental-health issue; ADHD tops, substance abuse also high

The most comprehensive report yet on mental disorders in children shows attention deficit hyperactivity disorder (ADHD) is the most commonly diagnosed problem in those aged 3-17, and the most common health issues for teenagers include addiction to drugs, alcohol and tobacco.

An estimated 13 to 20 percent of U.S. children experience a mental disorder in a given year, says a new report by the Centers for Disease Control and Prevention, and children are increasingly suffering from and being hospitalized for mood disorders like depression; that hospitalization rate has increased 80 percent from 1997 to 2010, says the report. And, while 3.5 percent of children under 18 have behavioral problems, almost 7 percent of them are diagnosed with ADHD.

About 4.7 percent of teens, or 1.7 million children aged 12–17, have disorders involving abuse and dependence upon alcohol, drugs or tobacco, says the report. Alarmingly, two-thirds of teenagers had an illicit drug use disorder, one million teenagers abused drugs or alcohol, and more than 695,000 were addicted to tobacco.

“This first report of its kind documents that millions of children are living with depression, substance use disorders, ADHD and other mental health conditions,” CDC Director Dr. Tom Frieden said. “No parent, grandparent, teacher or friend wants to see a child struggle with these issues. It concerns us all. We are working to both increase our understanding of these disorders and help scale up programs and strategies to prevent mental illness so that our children grow to lead productive, healthy lives.”

National Rx Drug Abuse Summit, a Kentucky product, seeks to make the nation face up to its problem

The second annual National Rx Drug Abuse Summit, organized by Eastern Kentucky's Operation UNITE, called for a national commitment to combating the country's drug-abuse problem

U.S. Rep. Hal Rogers, R-5th District

"People of great passion and perspective are here wanting to make an impact in their communities," said U.S. Rep. Hal Rogers, who first funded Operation UNITE. "The first step is we have to admit there is a problem. I don't think the country is there yet. We've got to face up to it. We've got to make this known ... and that we're not going to hide from it." Rogers was quoted in a news release.

UNITE (Unlawful Narcotics Investigations, Treatment and Education) serves 32 counties in Eastern Kentucky. It was created to fight illegal drug use through a comprehensive approach that includes educating youth and the public and coordinating substance abuse treatment while providing support for families affected by abuse.

In Kentucky, drug overdose is the leading cause of death and is more fatal than motor vehicle accidents, and the number of Kentucky drug-overdose deaths nearly quadrupling from 2000 to 2010. The nation has seen a similar trend, with the number of overdose deaths more than tripling over the decade.

“We can stop this epidemic,” Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention, said at the summit. “But we need everyone working together in an all-hands-on-deck approach.”

Themes highlighted at the summit included the need to provide better education about drug abuse, the need for greater use and seamless integration of state prescription-monitoring programs, the need to facilitate effective treatment and recovery programs, and the need for abuse-deterrent narcotic formulations.

“We were extremely pleased that so many individuals representing such a broad cross-section of interests shared their knowledge and expertise,” said Karen Kelly, who is leaving Operation UNITE to become district director on the Rogers congressional staff. To read more about the summit, click here.

Nightmare, drug-resistant superbugs, including one that kills half the people who get it, are a big threat

"Nightmare bacteria" leading to deadly infections that are difficult and sometimes impossible to treat are on the rise in American hospitals, and threaten to spread to otherwise healthy people outside of medical facilities, according to a federal Centers for Disease Control Vital Signs report published Tuesday.


These superbugs, carbapenem-resistant Enterobacteriaceae, or CRE, have become resistant to nearly all the antibiotics available today, including drugs of last resort. According to the report, CRE infections are caused by a family of germs that are a normal part of a person's healthy digestive system, but can cause infections when they get into the bladder, blood or other areas where they don't belong.

The report says almost all CRE infections are found in patients receiving serious medical care, and they kill up to half of patients who get bloodstream infections from them. In addition to spreading among people, CREs easily spread their antibiotic resistance to other kinds of germs, making those potentially untreatable as well.

Only 10 years ago, such resistance was hardly ever seen in this group of germs. Although these superbugs are uncommon, their prevalence has quadrupled in the past decade in medical facilities in 42 states, the CDC says.

The report calls for immediate action to stop the spread of these deadly infection; it is a critical time for U.S. doctors, nurses lab staff, medical facility leaders, health departments, states, policymakers and patients to help fight the spread through coordinated and consistent efforts.

The report asks patients to do three things: Tell your doctor if you have been hospitalized in another facility or country, take antibiotics only as prescribed, and insist that everyone wash their hands before touching you. For more details, click here for the Vital Signs report.

Health-care law addresses the most common chronic health problem in children, tooth decay, by requiring coverage for kids

Tooth decay is children's most common chronic health problem, and the 2010 federal health-care law addresses this problem by requiring insurers to cover pediatric dental services. But some advocates are concerned that the new benefits may not be sufficiently comprehensive or affordable, Michelle Andrews writes for The Washington Post.

She notes that by the time children enter kindergarten, more than a quarter of them have decay in their baby teeth. As they age, the problem gets worse and nearly 68 percent of those age 16 to 19 have decay in their permanent teeth, according the the Centers for Disease Control and Prevention. 
   
Beginning next year, the Affordable Care Act requires individual and small-group health plans cover pediatric dental services, unless a plan has a specific exemption under the law. Those services are already part of the Medicaid benefit package, but most Kentucky dentists don't accept Medicaid.
For the expansion to private insurance, "Coverage requirements will be determined by each state within guidelines set by the federal Department of Health and Human Services," Andrews writes.

Jill Midkiff, chief spokesperson for the Cabinet for Health and Family Services, said Kentucky is awaiting the publication of the final rule from HHS, which will define essential health benefits for each state and provide further guidance relating to coverage of benefits. Although no specific publication date for this rule has been announced, she said its release is expected within the next several weeks to allow insurers to modify existing health plans to be made available to individuals and small businesses for purchase through health exchanges by Oct. 1. (Read more)

Dollar General to sell tobacco in most of its stores by mid-2013, reflecting 'customer demand' and 'competition pressure'

By the middle of 2013, most of Dollar General's 10,000 U.S. stores will carry cigarettes and other tobacco products.. The company has made the decision in response to “competitive pressures” which came about when Family Dollar Stores, a key competitor, began adding cigarettes to its stores last year. In a press release issued by Dollar General, customer demand also drove the company's decision, citing their perception that their core customers -- mostly based in rural America -- are more likely to smoke than the national average.

A 2012 study by the American Lung Association indicated that while rural Americans do smoke more than urban Americans, geography is less a factor in determining who smokes than socioeconomic status. The study also found that pregnant rural women are far more likely to smoke than their urban counterparts. (See actual numbers from the Centers for Disease Control and the American Lung Association study here.)

G. Chambers Williams III of The Tennessean in Nashville reports that business analysts think the idea is a good one for the company, which tested the product placement last year in Nevada. Analyst Mark Montagna with Avondale Partners in Nashville explained that the company found that the average purchase per customer was $14 where tobacco was sold, versus an average of $11 otherwise. But, he added, the one challenge the company will face with tobacco products, additional shoplifting.
Anti-smoking advocates expressed regret at the business choice. (Read more)

CDC director: Flu season is three weeks early, could be a bad one

Prepare for a bad flu season. According to the Centers for Disease Control, this flu season seems to be ahead of schedule if you use the last decade as any judge of when the season should begin, which is usually around Christmas. Suspected cases have already showed up in Alabama, Louisiana, Florida, Mississippi, Tennessee and Texas, with two infant deaths already having been reported. (Getty Images)

Dr. Thomas Frieden, CDC director, sees good news in that fact that the nation seems well prepared this year. He told the Associated Press that more than a third of Americans have been vaccinated and that the vaccine is well matched to the strains of flu seen so far. (Read more)

UK creates nation's first cancer-reporting system that uses electronic health records

Kentucky has the highest incidence of cancer in the United States, but it is about to be a national leader in delivering information about cancer cases to researchers.

With the help of an almost $1 million Centers for Disease Control grant, the University of Kentucky has created the nation's first working model for electronic reporting of cases to the state cancer registry. Kentucky's cancer doctors will be able to feed clinical data to the state's epidemiologists immediately so that they can see and analyze cancer statistics more quickly that ever before.

“This project is laying the groundwork for electronic reporting not only in Kentucky but across the United States,” said Eric Durbin, director of Cancer Informatics at the Kentucky Cancer Registry and one of the investigators who created the model. (Read more)

Three or four more cases of fungal meningitis found in southern Pennyrile region -- two of those in Todd County

Kentucky now has five confirmed reports of fungal meningitis, and the Kentucky New Era reports that three or four have occurred in the southern Pennyrile region. The New Era's Nick Tabor writes that while no facilities in Kentucky have received the steroid responsible for the outbreak, the Centers for Disease Control confirms that the Saint Thomas Outpatient Neurosurgery Center in Nashville, Tenn., and two separate facilities in Crossville and Knoxville have distributed the steroid in injection form. All five Kentuckians who contracted the illness received medical care in Tennessee, the state reported.

The state’s Department for Public Health was notified this weekend of two cases in Todd County. One is Bill Johnson Sr., whose son ran against Rand Paul for U.S. Senate and Alison Lundergan Grimes for Kentucky Secretary of State. Carolyn Bland, director of the Trigg County Senior Center, was hospitalized Oct. 3 for meningitis, said her daughter, Beth Taylor. Eddie Lovelace, a longtime circuit judge from Clinton County, died of meningitis last month. He was being treated at St. Thomas when he died. 

As of Tuesday, health officials have reported 119 infections and 11 deaths across the nation, and six of those deaths were in Tennessee.

For the CDC’s complete list of the facilities that received the steroid, broken down by state, go here. 

Volunteer State becoming Salad State? CDC report shows Tennessee is getting less obese, leaving U.S.'s top 10

It can be done. A determined state can move the needle on its obesity numbers. Heidi Hall of The Tennessean reports that widespread efforts to change Tennesseans’ diet and exercise habits mean that the state’s percentage of obese residents have dropped for two consecutive years – something that hasn’t happened in more than a decade. "A new report from the Centers for Disease Control and Prevention moves Tennessee out of the top 10 most obese states for the first time since 1999 – it’s now ranked 15th – and," Hall notes, "is prompting cautious optimism in leaders charged with slimming down the state." (Associated Press photo)

The question, writes Hall, is what pellets of the state's shotgun approach are working. In a state that added bike lanes and sidewalks, altered its school lunches, and added fresh produce to convenience stores, where should credit go? “I think the biggest success is that we increased awareness around the issue,” said Ted Cornelius, the Tennessee Obesity Task Force’s co-chair. “We have the capacity to analyze barriers people face -- cost, access to healthy food and places to be active -- and we keep bringing those up to leaders in communities.”

The percentage of Tennesseans considered obese peaked at 32.9 percent in 2009 and dropped to 29.2 percent last year. Rural areas lead the drop, moving from 70.7 percent overweight in 2009 to 64.7 percent last year, but Schlundt said it may not be time to celebrate just yet. Rural residents took a similar jump upward from 2005-06, and both could be anomalies because the CDC surveyed fewer rural residents. (Read more)