Dawn, MD - Medical Blog

HIV Prevention Requires Combining Multiple Methods

admin — Wed, 10 Apr 2013 16:21:00 +0000

Researchers argue that a combination of behavioral, medical, and
structural approaches grounded on solid evidence, known as combination
prevention, is the best hope for successfully preventing HIV in the
future. In the first of six papers in The Lancet
Series on HIV prevention, Professor Michael Merson (Duke Global Health
Institute, Duke
University, Durham, NC, USA), Jeffrey O’Malley (HIV/AIDS Practice,
UN Development Program, New York, USA) and colleagues insist that the
mistakes of the mid-1990s cannot be repeated.

The authors outline the brief history of the HIV/AIDS pandemic. In
1981, the Centers for Disease Control and Prevention, USA, published
the first confirmed reports of AIDS. In recent years, researchers have
developed antiretroviral drug (ARV) treatment, and donor programs are
discussed at high level UN meetings. Merson and O’Malley also detail
the difficulties seen worldwide in accepting and acknowledging the
disease as well as the inconsistent and poor responses of many
governments in the earlier years. For example, in the mid-1990s the
pandemic expanded substantially as many countries reduced political and
financial support for HIV/AIDS issues. “Early prevention successes
evolved from collective responses generated by people living with
HIV/AIDS and community groups, and confronted the stigma,
discrimination, and denial associated with the disease. A global
response, involving social factors such as sexual behaviour, injecting
drug use, and gender inequalities, is needed to fully address the
HIV/AIDS pandemic,” write the authors.

Analyzing data on country-specific HIV cases and incidence, the
researchers maintain that current global prevention efforts are still
unacceptable – fewer than 10% of at-risk individuals in the world
receive important prevention services. “Expansion of these services
could avert more than half the HIV infections projected to occur by
2015 and save $24 billion in treatment costs,” they write. If 70% of
males are circumcised, according to one study, about 700,000 cases of
HIV could be prevented in sub-Saharan Africa up to 2015. Although the
last five years has seen a tenfold increase in the number of people
receiving ARV therapy, there are five new HIV infections for every two
patients on ARVs in 2007.

The authors say that resources are not available to reach the goals set
out in the 2006 UN World Summit – that is, a US$42.2 billion package
for HIV prevention and care leading to almost universal coverage by
2010. “Successful prevention requires knowledge of the nature of the
epidemic in individual countries, as well as community and country
contexts,” they write. More parties are recommending that HIV
prevention be combined with an overall strengthening of the health
system in every affected country. The researchers write: “We need not
only more managers, public-health experts, physicians, and nurses, but
also a new cadre of community workers whose education is rooted in
community development, gender equity, human rights, and public health,
and who will be equally powerful in the promotion of hygiene,
sanitation and use of bednets as they are in the generation of a
community response to HIV prevention.”

“We now require an urgent and revitalised global movement for HIV
prevention that supports a combination of behavioural, structural, and
biomedical approaches and is based on scientifically derived evidence
and the wisdom and ownership of communities…With millions of people
on treatment and the incidence of HIV infection falling in places, many
involved in public health and public policy are calling for a shift of
attention from HIV to other diseases…HIV prevention must remain one
of the world’s top health and development priorities – now and for a
generation to come. The mistakes of the mid-1990s, when HIV/AIDS
slipped down the political agenda and the pandemic greatly expanded,
must not be repeated,” conclude the authors.

The history and challenge of HIV prevention
Jeffrey O’Malley et al.
The Lancet (2008).
Click
Here to View Journal Web Site

: Peter M Crosta

Lancet Publishes Article About Behavioral HIV Prevention Strategies

admin — Tue, 09 Apr 2013 16:18:00 +0000

“Behavioral Strategies To Reduce HIV Transmission: How To Make Them Work Better,” Lancet: Thomas Coates of the University of California-Los Angeles and colleagues make five points in the paper about behavioral HIV prevention strategies. First, they write that the “aggregate effect of radical and sustained behavioral changes in a sufficient number of individuals potentially at risk” for HIV is “needed for successful reductions” in transmission of the virus. Second, “combination prevention is essential” because HIV prevention is “neither simple nor simplistic,” according to the authors. Third, prevention programs “can do better” by “aiming for many goals … that are achieved by use of multilevel approaches” with both HIV-positive and HIV-negative populations, the authors write. Fourth, “prevention science can do better,” the authors write, adding that interventions “derived from behavioral science have a role in overall HIV prevention efforts, but they are insufficient when used by themselves to produce substantial and lasting reductions in HIV transmission between individuals or entire communities.” Lastly, the researchers write that “we need to get the simple things right,” adding, “The fundamentals of HIV prevention need to be agreed upon, funded, implemented, measured and achieved.” They conclude, “That, presently, is not the case” (Coates et al., Lancet, 8/23).

Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.

Vancouver’s Supervised Injection Site Leads To 35 Percent Reduction In Overdose Deaths

admin — Mon, 08 Apr 2013 16:15:00 +0000

Illicit drug overdose deaths in Vancouver’s Downtown Eastside dropped by 35 per cent after the establishment of Insite, North America’s first supervised injection facility, according a new study by researchers at the University of British Columbia and the British Columbia Centre for Excellence in HIV/AIDS.

Published in The Lancet, the study is the first to assess the impact of supervised injection sites on overdose mortality. Researchers compared nearly 300 case reports from the British Columbia Coroners Service documenting all illicit drug overdose deaths in Vancouver between January 1, 2001 and December 31, 2005.

Compared to the 35 per cent reduction in overdose deaths in the immediate vicinity of Insite following its opening in September 2003, overdose deaths in the rest of Vancouver declined only nine per cent over the same period. No overdose deaths have been recorded at Insite since the facility’s opening. The researchers also noted that there was no evidence of significant changes in drug supply or purity during the study period.

“This study provides the first unequivocal scientific evidence of the benefits of supervised injection facilities, and clearly demonstrates that facilities such as Insite are saving lives and playing a vital role in reducing the harms associated with illicit drug use,” says co-author Dr. Julio Montaner, director of the BC-CfE and Chair of AIDS Research at the UBC Faculty of Medicine.

“Research results clearly show facilities such as Insite could literally be the difference between life and death for many people,” says senior author Dr. Thomas Kerr, an associate professor at UBC and co-director of the Urban Health Research Initiative (UHRI), a program of the BC-CfE.

Insite is a pilot facility with 12 injection seats in a neighbourhood with an estimated 5,000 injection drug users. Currently operating at capacity, Insite staff supervise more than 500 injections on an average day. Larger reductions in overdose deaths would require an expansion of the facility.

Established in 2003 in response to an HIV epidemic and escalating overdose death rates in Vancouver’s Downtown Eastside, Insite enables injection drug users to consume pre-obtained drugs under the supervision of nurses. Counsellors are also available onsite to provide support and referrals to programs, including addiction treatment. An extensive scientific evaluation by UHRI researchers has previously demonstrated the facility’s ability to reduce HIV risk behaviour, increase access to addiction treatment and primary health care services, and reduce healthcare costs in the long term.

On January 15, 2010, the BC Court of Appeal upheld a decision by the BC Supreme Court and ruled that Insite, a health care facility, is under provincial jurisdiction. An earlier BC Supreme Court decision also ruled that Insite helped ensure the constitutional right to health by providing an essential health service.

The federal government has submitted an appeal to the Supreme Court of Canada. The case is scheduled to be heard on May 12, 2011. Several groups and organizations, including the Canadian Medical Association, the Canadian Public Health Association, and the Canadian Nurses Association have obtained intervener status in the upcoming Supreme Court of Canada case, and will be calling for the continued operation of Insite.

Source:
Brian Lin
University of British Columbia

Nearly Half Of Washington, D.C., Area AIDS Cases Are In Suburbs, Study Finds

admin — Sun, 07 Apr 2013 16:12:00 +0000

Residents of the Maryland and Virginia suburbs account for nearly half of AIDS cases in the Washington, D.C., area, but suburban governments lag behind the district in efforts to slow the spread of the disease, according to a study released Tuesday by the Washington AIDS Partnership, the Washington Post reports.

The study found that 46% of the 17,000 area residents living with AIDS reside in the suburbs, while 54% live in the district. However, the infection rate in the suburbs is much lower than in the district, where 3% of residents have HIV or AIDS and rates are considered to be at epidemic levels, the study found. About 13,000 people in the greater Washington, D.C., region are HIV positive, the Post reports.

The study recommends that suburban governments establish standards calling for health care providers to routinely test all patients for HIV during medical visits, unless a patient opts out. It also recommends that all emergency department patients be offered an oral HIV test. In addition, governments should do more to prevent the spread of HIV, such as improving sex education in schools, the study says.

The Washington AIDS Partnership, an initiative of the Washington Regional Association of Grantmakers and Kaiser Permanente, in 2005 issued a similar report that focused on the district’s response to HIV/AIDS. Channing Wickham, executive director of the partnership, said the 2005 study was a “blueprint for action” for the district. In the past three years, D.C. has provided millions of condoms to city residents, established a school sex education curriculum and offered testing for sexually transmitted infections to all public high school students. According to the study, some suburban school districts ban distribution of condoms in schools, and parents in Montgomery County, Md., filed a lawsuit against the school to stop some aspects of sex education.

Some Maryland and Virginia officials disputed the notion that their governments are not devoting significant resources to fighting HIV/AIDS, the Post reports. Elaine Martin, director of HIV prevention for Virginia, and Heather Hauck, director of the Maryland Department of Health and Mental Hygiene, said low federal funding is a challenge for state governments (Fears, Washington Post, 4/27).

Washington Post Column Discusses Study’s Findings

Although the study raises “big situations that involve health care costs, treatment centers, federal programs and housing,” the “easiest, cheapest and best long-term solution is simply information,” Washington Post columnist Petula Dvorak writes. She notes that the study called HIV prevention programs in suburban schools “inconsistent and timid.”

Dvorak continues, “Outreach workers who go to these schools told me that AIDS is now seen as a chronic disease, rather than a death sentence.” She adds, “It’s terrific that medicine has found ways to help people with the virus live full, productive lives. But the unnerving result is that the fading of the lesion-pocked AIDS patient at death’s door as the poster child for the virus is fertile ground for the epidemic’s rebirth” (Dvorak, Washington Post, 4/27).

McDonnell Questioned About Sex Education

In related news, Virginia Gov. Bob McDonnell (R) was asked during a radio interview Tuesday if he believes “AIDS educators should come in to public schools in Virginia and demonstrate how to properly use a condom,” the AP/WTKR reports. McDonnell did not state his position on the issue but said he “think[s] there would be a lot of parents in those communities that would probably object to that, who would say, ‘This is my responsibility to teach my children about these issues.’” He continued, “And there’s obviously the question of what’s age-appropriate, certainly not elementary school.”

McDonnell said abstinence is the best approach to sex education but that information about safer sex should be available to people who do not remain abstinent. He added that public health and education officials would be the ones to address such issues, according to the AP/WTKR.

The AP/WKTR notes that McDonnell is an “unflinching social conservative” who has faced criticism over recent decisions to omit same-sex partners from an executive order banning discrimination in the state work force and to designate April Confederate History Month without acknowledging slavery, for which he later apologized (Lewis, AP/WTKR, 4/27).

Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women’s Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women’s Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.

Nigeria Has Established 74 ARV Treatment Centers Nationwide, Health Minister Says

admin — Sat, 06 Apr 2013 16:09:00 +0000

Seventy-four antiretroviral therapy treatment centers have been established across Nigeria to help provide antiretroviral drugs to HIV-positive people, Health Minister Eyitayo Lambo said Thursday in a statement, AFP/Yahoo! News reports (AFP/Yahoo! News, 3/9). Nigeria in December 2005 announced it would begin a program that aims to provide antiretroviral drugs at no cost to about 250,000 HIV-positive residents. Only about 40,000 of the 3.5 million HIV-positive people in the country currently receive subsidized antiretroviral treatment. The program will be funded by a $250 million grant from the Global Fund To Fight AIDS, Tuberculosis and Malaria, as well as with money made available when the country’s international debts were canceled. The U.S. government will provide most of the remaining money needed to implement the program (Kaiser Daily HIV/AIDS Report, 1/3). Treatment centers currently operate in the capital, Abuja, and in 35 of the country’s 36 states. The last state is expected to have a treatment center by the middle of this year, Lambo said (AFP/Yahoo! News, 3/9).

“Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . ?© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

British International Travellers Are Warned To Safeguard Against Life Threatening Diseases

admin — Fri, 05 Apr 2013 16:06:00 +0000

The Health Experts from Association of British Hujjaj (pilgrims) UK (ABH) a national charity working for the welfare and wellbeing of the British international travellers have launched a campaign to raise awareness of pre-travel health and safety issues amongst British overseas travellers, as summer vacation is approaching fast.

In 2007 there were 12.2 million visits made abroad by UK residents visiting friends and relatives. A substantial number of these travellers tend to visit developing countries such as South Asia, Africa and the Middle East mainly with endemic infectious diseases where a high proportion of these travellers contract avoidable infectious diseases.

The Health Experts from ABH strongly urge the travellers to take preventative measures against life threatening infectious diseases like Meningitis, Malaria, Hepatitis and Typhoid.

Meningitis a bacterial infection spread through contact such as sneezing and coughing.. Immunisation is mandatory to all the Hajj and Umrah pilgrims and certificate of vaccination is required to obtain visa from Saudi Embassy.

Malaria is transmitted by mosquito bites and travels through the blood and into the liver. There is no vaccine so travellers need to take preventative medication and use insect repellent and mosquito nets.

Hepatitis A spreads through contaminated food and water. It occurs where sanitation and hygiene is poor.. Hepatitis B is highly contagious and can be passed via, blood transfusion or needles. Travellers must not share needles, razors, toothbrushes, manicure tools or other items that could bear contamination blood to avoid Hepatitis.

Typhoid fever a bacterial disease common in many developing countries, it is spread through contaminated food and water.

The Health Experts warn the travellers to protect themselves and others, and to take the threat of contracting infectious diseases abroad seriously. Be safe than sorry! See your doctors and get vaccinated before travelling.

Source:

Association of British Hujjaj (Pilgrims) UK (A.B.H)

AP/International Herald Tribune Examines Efforts Aimed At Providing Prison Inmates With Condoms To Reduce Spread Of HIV, STIs

admin — Thu, 04 Apr 2013 16:03:00 +0000

The AP/International Herald Tribune on Monday examined nationwide efforts to provide prison inmates with condoms in an attempt to reduce the spread of HIV and other sexually transmitted infections. According to the AP/Herald Tribune, efforts by HIV/AIDS and prisoners’ rights advocates to distribute condoms in prisons have gone “almost nowhere” because some prison officials and politicians argue that they encourage sexual activity among inmates and can be used to hide drugs.

Vermont and five other cities in the U.S. allow inmates regular access to condoms, the AP/Herald Tribune reports. Vermont’s Department of Corrections has provided condom access in prisons since 1992 even though prison regulations ban sexual activity. The program provides inmates one condom at a time if they request it from a health worker. “It’s a courageous position that Vermont took then and continues to have now,” the corrections department’s health services director, Dolores Burroughs-Biron, said, adding that there have been no reports of security problems as a result of the program.

Legislation introduced by Rep. Barbara Lee (D-Calif.) this year to allow condom access in federal prisons has “made little headway,” according to the AP/Herald Tribune. A similar measure introduced in Illinois failed in a House committee, and a proposal in California was vetoed in October by Gov. Arnold Schwarzenegger (R), who said the proposal contradicted prison rules that ban sexual activity. Despite the veto, Schwarzenegger has commissioned the state corrections department to examine the feasibility of a pilot condom distribution program in a state prison. “When more than 90% of incarcerated people return to our communities, taking a head-in-the-sand approach to the fact that our prisons have become a breeding ground for HIV/AIDS poses a serious public health risk,” Lee said.

Condom programs are under way in jails in Los Angeles, New York City, Philadelphia, San Francisco and Washington, D.C. According to Mary Sylla — policy director for the Center for Health Justice, which distributes condoms in a prison unit reserved for men who have sex with men in Los Angeles — there have been no security problems at the facility as a result of the program. “If there was a case of somebody doing something horrible with a condom, we would have heard about it — it would be all over the corrections community,” she said, adding, “But it doesn’t happen.”

However, some corrections officials “insist there are dangers” to condom distribution, the AP/Herald Tribune reports. Glenn Goord, New York state’s former corrections commissioner, said that condoms are used to transport drugs and might encourage prison rapists, who could use them to avoid DNA evidence. There are no “authoritative” U.S. data on HIV/AIDS rates in federal prisons, but CDC released a report last year recommending that lawmakers consider a federal condom-distribution policy, the AP/Herald Tribune reports (AP/International Herald Tribune, 11/19).

HIV – Updated Information On Aptivus(R) (tipranavir) Clinical Trial Surveillance

admin — Wed, 03 Apr 2013 16:00:00 +0000

Boehringer Ingelheim is committed to patient safety and to improving the lives of people living with HIV. Boehringer Ingelheim actively conducts rigorous safety monitoring of all of its products in clinical trials and during including post-marketing surveillance. Over the course of all clinical trials with Aptivus(R) (tipranavir) capsules in anti-HIV combination treatment, Boehringer Ingelheim has received 14 reports of intracranial hemorrhage events, including 8 fatalities, in 13 out of 6,840 HIV-1 infected individuals included in the clinical programme.

There have been no spontaneous reports of intracranial hemorrhage on marketed Aptivus(R) so far, nor have any of these events been observed in the pediatric or treatment-naive clinical trials of Aptivus(R).

Boehringer Ingelheim conducted a thorough case-by-case analysis of each of the 14 cases of intracranial hemorrhage. Many of the patients experiencing intracranial hemorrhage had other medical conditions, including central nervous system lesions, head trauma, recent neurosurgery, coagulopathy, hypertension or alcohol abuse, or were receiving concomitant medications that may have contributed to these events.

No pattern of abnormal hematologic or coagulation parameters was observed. Therefore, routine measurement of coagulation parameters is not currently indicated in the management of patients on Aptivus(R).

Individuals with advanced HIV disease and AIDS, such as those treated in Aptivus(R) clinical trials, have previously been observed to have an increased risk of intracranial hemorrhage. The rate of intracranial hemorrhage events in Aptivus(R) clinical trials corresponds to a rate of 0.2/100 patient exposure years (PEY). A literature review of intracranial hemorrhage in HIV-infected individuals found that the rate observed in AIDS patients not receiving combination antiretroviral therapy is in the same range (0.2/100 PEY) as reported in Aptivus(R) clinical trials.

A relationship between intracranial hemorrhage and Aptivus/ritonavir treatment has not been established. There have been no spontaneous reports of intracranial hemorrhage on marketed Aptivus(R) nor have any of these events been observed in the pediatric or treatment-naive clinical trials of Aptivus(R).

In an in-vitro experiment, tipranavir was observed to inhibit human platelet aggregation. Therefore, Aptivus(R)/ritonavir should be used with caution in patients who may be at risk of increased bleeding from trauma, surgery or other medical conditions, or who are receiving medications known to increase the risk of bleeding such as antiplatelet agents or anticoagulants.

Boehringer Ingelheim has informed regulatory authorities and is in the process of notifying investigators and healthcare professionals about the occurrence of intracranial hemorrhage in clinical trials. Boehringer Ingelheim is also working with regulatory authorities to update the Warnings and Precautions section of the Aptivus(R) product labeling and Patient Package Insert (PPI).

Patients taking Aptivus(R)/ritonavir should not discontinue or modify their treatment with Aptivus/ritonavir or any other medications without first speaking with their doctor to evaluate the appropriate course of therapy for their individual needs.

Positive benefit-risk profile of Aptivus(R)/ritonavir remains unchanged Aptivus(R)/ritonavir, at the approved dose (500 mg/200 mg twice daily), has demonstrated significant benefit for the patient population for which it is indicated, HIV-1 infected adult patients with evidence of viral replication, who are highly treatment-experienced or have HIV-1 strains resistant to multiple protease inhibitors.

In a 24-week analysis of the RESIST studies, comprised of 1,159 patients, regimens containing Aptivus(R)/ritonavir produced twice the treatment response in patients with PI-resistant HIV than other commonly used ritonavir-boosted PIs. Investigators selected a comparator PI that offered patients the best opportunity for treatment response based on resistance testing. The comparator PIs were lopinavir, indinavir, saquinavir and amprenavir. Patients in the RESIST trials were highly treatment-experienced and the majority (86%) were at least partially resistant to the comparator PI chosen. Over half of the patients had prior AIDS. 48- week data from the RESIST studies, which was presented this year at the 13th Conference on Retroviruses and Opportunistic Infections(CROI), showed Aptivus(R)/ritonavir demonstrated a durable response consistent with the 24-week analysis.

Boehringer Ingelheim continues to be diligent in surveillance of Aptivus(R)/ritonavir safety in clinical trials and post-marketing reporting. In addition, we will work aggressively with outside investigators to establish the frequency of intracranial hemorrhage in HIV-1 infected patients with advanced disease receiving boosted protease inhibitors. Boehringer Ingelheim will provide ongoing updates of new information as it becomes available.

Aptivus(R) Clinical Trial Program Boehringer Ingelheim is committed to understanding the full clinical utility of Aptivus(R) for the treatment of HIV-1 and is actively conducting a clinical trial program. The Aptivus(R) program is comprised of ongoing and planned studies in more than 1,000 patients with a spectrum of antiretroviral experience, including pediatric, racially and gender diverse, or hepatitis co-infected patients.

About Aptivus(R)

Aptivus(R) is a new non-peptidic protease inhibitor which works by inhibiting the viral protease, an enzyme needed to complete the HIV replication process. It is approved for combination antiretroviral treatment of HIV-1 infected adults that are highly pre-treated with virus resistant to multiple protease inhibitors.

Based on available clinical and in vitro data, Aptivus(R) is active against most strains of HIV-1 that are resistant to commercially available protease inhibitors. The safety and efficacy of Aptivus(R) in paediatric patients has not yet been established. Currently, phase 2 and 3 studies in paediatric and other populations are fully enrolled and ongoing.

In studies to date, Aptivus(R) has been well tolerated by most patients and has a safety profile similar to other PIs. The most commonly reported side effects of at least moderate intensity in patients enrolled in the RESIST studies taking Aptivus(R) are gastrointestinal, including diarrhoea, nausea, vomiting and abdominal pain. Fever, fatigue, headache, bronchitis, depression and rash also occurred.

Aptivus(R) boosted with low-dose ritonavir has been associated with reports of hepatic adverse events, which have included some fatalities. Extra vigilance is warranted in patients with chronic hepatitis B or hepatitis C co-infection, as these patients have an increased risk of liver toxicity. The most common moderate to severe laboratory abnormalities were elevated liver enzymes and elevated lipid levels. Most laboratory abnormalities were asymptomatic and most patients were successfully treated without discontinuation.

Aptivus(R) does not cure HIV infection/AIDS or prevent the transmission of HIV to others. Patients may continue to develop opportunistic infections and other complications associated with HIV disease.

Apart from the EU, Aptivus(R) has received US marketing authorization by the FDA and was launched there in June 2005. Additional marketing authorizations from different countries have been received or are expected.

Boehringer Ingelheim

Boehringer Ingelheim is committed to the research and development of novel antiretroviral agents. Apart from Aptivus(R), Viramune(R) (nevirapine) is a product of original research done at Boehringer Ingelheim. Viramune(R) was the first member of the non-nucleoside reverse transcriptase inhibitor (NNRTI) class of anti-HIV drugs on the market. The company is involved in basic research in that area and is committed to improving HIV therapy by providing physicians and patients with innovative antiretroviral treatment options.

boehringer-ingelheim

CDC Awards $42M In HIV Prevention Grants

admin — Tue, 02 Apr 2013 15:57:00 +0000

On Tuesday, the Centers for Disease Control and Prevention awarded $42 million in grants to 133 community-based organizations to support HIV/AIDS prevention efforts, The Hill’s “Healthwatch” reports. The awards target high-risk populations, including blacks, Hispanics, men who have sex with men and injection drug users, according to CDC.

The grants are a “critical” component of CDC’s HIV prevention strategy and align with the National HIV/AIDS Strategy released last month, CDC Division of HIV/AIDS Prevention Director Jonathan Mermin said (Pecquet, “Healthwatch,” The Hill, 8/3). The new strategy — the first-ever coordinated national plan to combat the HIV/AIDS epidemic — aims to reduce HIV transmissions and infections, lower HIV-related health disparities, increase care quality and expand access to services (Women’s Health Policy Report, 7/15).

The average award is about $323,000 annually for five years. Specifically, the grants will be used to implement prevention programs for people with HIV and those in high-risk groups; increase HIV testing and knowledge of HIV status in at-risk communities; and monitor the program’s effects and behavioral outcomes (“Healthwatch,” The Hill, 8/3).

Seasonal Stomach Virus Arrives In New York City

admin — Mon, 01 Apr 2013 15:54:00 +0000

Illness from a common infection called norovirus has spiked in New York City in recent weeks, the Health Department reported. Emergency department visits for vomiting and diarrhea, the most common symptoms, have jumped from 300 visits per day to nearly 500 visits per day since November, prompting health officials to remind all New Yorkers to stay home when they are sick and to wash their hands frequently. Norovirus, commonly known as stomach flu, is a seasonal illness that typically peaks during the winter months, here and across the nation.

Norovirus rarely causes more than a few days of illness. In addition to vomiting and diarrhea, the symptoms may include nausea, stomach cramping, fever, chills, aches and tiredness.

“The best way to stop the spread of norovirus is to wash your hands regularly with soap and stay home from work or school if you are sick,” said Dr. Sharon Balter, Director of Enteric Disease for the Health Department’s Bureau of Communicable Disease. “Norovirus is common at this time of year and is not serious for most people, but it is important to take these steps to keep others from getting sick.”

There are no specific treatments for stomach viruses. People with diarrhea or vomiting, particularly young children, should drink plenty of fluids to prevent dehydration, the most concerning consequence of stomach viruses. If an infected person stops urinating or cannot keep fluids down, he or she should seek health care promptly.

People can become sick with this stomach virus in several ways, including:

- Eating food or drinking liquids that are contaminated with norovirus

- Touching surfaces that are contaminated with norovirus, and then putting their hands in their mouths

- Having close contact with a person who is sick – sharing foods or utensils, for example, or changing a sick child’s diaper.

How to prevent stomach infections:

- Wash your hands often with soap for at least 20 seconds, especially after using the bathroom, changing diapers, or before touching food.

- Supervise young children washing their hands after using the bathroom and before eating.

- If you are sick with vomiting or have diarrhea, stay at home until you recover – especially if you work in a restaurant or day care.

- If someone is sick, clean and disinfect surfaces that may have become dirty with vomit or stool as soon as possible with a germ-killing cleaner (i.e. a cleaner that has bleach in it). Throw out any vomit or stool you clean up in sealed plastic bags. Remember to wear gloves when cleaning up contaminated areas and wash your hands after cleaning.

Currently, the Health Departments only source of information on noroviral infections in New York City is emergency department data. This past October, the Health Department proposed to the Board of Health that all New York City laboratories be required to report norovirus cases to the Department. This measure would allow the Health Department to better monitor norovirus trends and target prevention messages. The Board will consider the proposal in January.

For more information on noroviruses, please visit here.

NYC Health