Flu Vaccine Is Only Moderately Protective This Year, CDC Says

This year’s flu vaccine is offering moderate protection against the main family of viruses causing illness, data released Thursday by the Centers for Disease Control and Prevention show.

The data comes as what has been a pretty active flu season is near its apex in many parts of the country.

“We won’t know when the peak has occurred until we’ve passed it and have a couple of weeks to look back,” said Lynnette Brammer, head of domestic influenza surveillance at the CDC. “We hopefully are approaching the peak but we may not be there yet.”

Overall, getting a flu shot cut one’s risk of contracting flu and needing to see a doctor by 48 percent this season, when the effectiveness of the various components of the vaccine were assessed together, according to the report published in the CDC’s online journal Morbidity and Mortality Weekly Report.

Far and away the most common cause of influenza so far this year is the influenza A virus family known as H3N2. Seasons when H3N2 viruses dominate are typically harsh because the virus is especially hard on older adults. Older adults also get less benefit from flu vaccines than healthy younger people.

Mixed effectiveness

This year is not an exception. The CDC data, drawn from five surveillance sites across the country, suggest that the H3N2 component of the 2016-17 flu vaccine offered about 43 percent protection against medically attended influenza.

To put that in context, the influenza B component of the vaccine this year appears to offer about 73 percent protection. The CDC could not estimate vaccine effectiveness for the influenza A H1N1 component of the vaccine because those viruses haven’t played much of a role so far this winter.

“It’s not as good as we would like to see, and we’ve seen higher for some of the seasons — more for H1N1 and for [flu] B,” said Brendan Flannery, an epidemiologist with the CDC’s influenza division.

“But for H3N2, it’s as good as we have seen for some of the H3N2 seasons that have been well matched.”

In the last H3N2-dominant flu season, in 2014-15, the target virus in the vaccine was not well matched to the viruses that were making people sick. That year data suggested the vaccine offered virtually no protection against H3N2 viruses.

The need for better vaccines

“Forty percent to 50 percent is a lot better than zero, but what it really begs the question is: Why are we not working hard to get new and better flu vaccines?” said Michael Osterholm, director of the University of Minnesota’s Center for Infectious Diseases Research and Policy and a long-time advocate for the development of more effective flu vaccines.

“Last year we spent over a billion dollars researching new HIV vaccines — an amount that I think is an important investment. But the best estimate we can come up with is we only spend about $35 million globally on … research on new game-changing flu vaccines.’’

The US findings mesh with vaccine effectiveness results seen elsewhere this season.

Last week Canadian researchers reported they are seeing about 42 percent protection from the H3N2 component of the vaccine north of the border. And European scientists reported vaccine effectiveness of 38 percent for H3N2 on Thursday.

Jacqueline Katz, deputy director of the CDC’s influenza division, said a theory behind the poor performance of the H3N2 component of the vaccine relates to the way flu vaccine is produced.

Most influenza vaccine is produced in hen’s eggs; the viruses have to adapt to grow in eggs. That’s true of all families of flu but for some reason the H3N2 viruses adapt in ways that introduce important differences. In essence, the viruses produced in the eggs are different from the viruses circulating in people and don’t adequately prime immune systems to recognize and fend off those viruses. In some years those differences are more pronounced than others.

Sudden Death Warning Over Faulty Heart Gene

An estimated 620,000 people in the UK have a faulty gene that puts them at risk of developing coronary heart disease or sudden death, and most are unaware, a charity has warned.

The British Heart Foundation said the figure was 100,000 more than had been thought and could be even higher.

It said there was now a better grasp of the prevalence of inherited conditions.

A child of someone with an inherited heart condition can have a 50% chance of inheriting it themselves.

The charity warned that the overall figure for those with the faulty gene could be much higher because of as yet undiscovered faulty genes and under-diagnoses.

Each week in the UK, around 12 seemingly healthy people aged 35 or under are victims of sudden cardiac death with no explanation, largely due to undiagnosed heart conditions.

Former England and Nottinghamshire cricketer James Taylor had to retire last year, at the age of 26, after he was diagnosed with the serious heart condition arrhythmogenic right ventricular cardiomyopathy.

Radio Four’s Today programme that he had been warming up for the first game of the season in Cambridge when his heart started “going mental in my chest”.

He said: “You could see my shirt moving, that’s how hard my heart was beating inside my chest…

“I went off, I had some oxygen, then I went to hospital some hours later.

“When I walked in to hospital they said it was a miracle I was able to walk in.

“My heart rate was going at 265 beats per minute.”

A normal resting heart rate is 60 to 100 beats a minute, but Taylor’s remained at 265 for six to seven hours – “the equivalent of doing five, six marathons.”

He now treats the condition with medication and said he was fortunate to survive.

“I’m still alive. I should have died – that’s the scary thing about these inherited heart conditions.

“A lot of people don’t get the opportunities I had and it’s often too late.”

Research has helped to discover many of the faulty genes that cause inherited heart conditions.

This has led to the development of structured genetic testing services for those at highest risk for some of these conditions.

However, the British Heart Foundation says more research is urgently needed.

Inherited heart conditions: What you need to know

  • Many people with an inherited heart condition have no symptoms, but some can develop some warning signs including dizzy spells, palpitations and blackouts
  • Screening and genetic testing can help identify problems
  • Doctors will suggest you be tested if a family member has been diagnosed with an inherited heart condition, there is a family history of premature deaths or you have been diagnosed with angina or had a heart attack at a young age
  • If you are diagnosed with an inherited heart condition, monitoring and treatment can reduce the risk of a sudden heart attack or cardiac arrest
  • Speak to your GP if you are concerned

Prof Sir Nilesh Samani, BHF medical director, said: “The reality is that there are hundreds of thousands of people across the UK who are unaware that they could be at risk of sudden death.

“If undetected and untreated, inherited heart conditions can be deadly and they continue to devastate families, often by taking away loved ones without warning.

“We urgently need to fund more research to better understand these heart conditions, make more discoveries, develop new treatments and save more lives.”

Diabetes May Be A Major, Overlooked Reason Americans Are Now Dying Earlier

In 2015, a blockbuster study came to a shocking conclusion: Middle-age white Americans are dying at younger ages for the first time in decades, despite our advances in medical technology and the positive trends in other wealthy countries.

The research, by Princeton’s Anne Case and Angus Deaton, highlighted the links between economic struggles, suicides, and alcohol and drug overdoses. Since then, researchers have been scrambling to fully explain the trend, which now seems to be affecting the entire population. The efforts have suggested it’s not just “deaths of despair”— from opioids, alcohol, and suicides — that account for the dip in life expectancy, but that violence and cardiovascular disease seem to be major contributors, too.

Now, a new study provides another clue about what’s behind the backward sliding of American mortality: the hidden toll of diabetes.

Diabetes’ prevalence has exploded in the US over the past 20 years. Nearly 30 million Americans live with the disease today — more than three times the number in the early 1990s.

And researchers have long known that diabetes is an underreported cause of death on death certificates, the primary data source for determining life expectancy trends. That’s because people with diabetes often have multiple health conditions, or “comorbidities,” such as cardiovascular disease, high blood pressure, high cholesterol, obesity, and even cancer.

When both diabetes and heart disease are listed on a death certificate, the decision to list diabetes as the primary cause of death is “highly variable,” said Andrew Stokes, assistant professor of global health at Boston University’s School of Public Health. “Often times, the [death certificate] certifier will code the death as being caused by heart disease rather than a death from diabetes,” he added. “So to some extent, deaths that should be attributed to diabetes go to other causes.”

For new research in the journal PLoS One, Stokes and his co-author Samuel Preston of the University of Pennsylvania decided to look at more granular administrative records and surveys — the National Health Interview Study and the National Health and Nutrition Examination Survey — to find out whether they could estimate how often diabetes might be the primary but overlooked cause of death.

To come up with an estimate, they calculated the prevalence of diabetes in the population and the increased risk of death among people with diabetes during five years of follow up.

Their results were astounding. While death certificates usually suggest that around 3.5 percent of deaths were caused by diabetes, the researchers found the number may be closer to 12 percent — three times higher than the typical estimates. Among obese individuals, the death rate from diabetes was even higher, at 19 percent.

That means that while diabetes is generally listed as the seventh most common cause of death in America, said Stokes, their results suggest it’s probably the third leading cause of death after cancer and heart disease.

“When we look at that surprising decline in life expectancy in 2015, and argue about the causes, we believe diabetes is somewhat obscured from this debate because it doesn’t jump out in the mortality statistics,” Stokes said. “For that same reason it may not be implicated in trends as much as it should be.”

As a result, relatively fewer health dollars and less policy attention are focused on diabetes compared to other more obvious contributors to this health crisis. If Preston and Stokes are correct, though, that needs to change.

“Mortality has been improving unusually slowly for about the last eight to 10 years,” said Preston. “We know the opioid epidemic is part of the problem. But I don’t think it accounts for all of the difficulties we’re facing. And an obvious place to look is obesity and diabetes.”

Brazil Sees Sharp Rise In Yellow Fever Cases

Health officials in Brazil say there has been a sharp rise in the cases of yellow fever in the country. They said there had been 63 confirmed cases of the mosquito-borne illness so far this year, up from seven in the whole of 2016.

Most of the cases have been in rural areas of Minas Gerais state, a Ministry of Health statement said.

The government has sent two million doses of yellow fever vaccines to the state.

The governor of Minas Gerais has declared a 180-day state of emergency.

What is yellow fever?

  • Caused by a virus that is transmitted to humans by mosquitoes
  • Difficult to diagnose and often confused with other diseases or fevers
  • Most people recover after the first phase of infection that usually involves fever, muscle and back pain, headache, shivers, loss of appetite, and nausea or vomiting
  • About 15% of people face a second, more serious phase involving high fever, jaundice, bleeding and deteriorating kidney function
  • Half of those who enter the “toxic” phase usually die within 10 to 14 days

of the 63 confirmed cases in Brazil, 35 have proved fatal, Brazilian Health Ministry figures show.

That is the highest number of deaths since at least 2008, the year to which Ministry of Health records date back.

There have also been three confirmed cases in Sao Paulo, Brazil’s most populous state, and one each in Espiritu Santo and Bahia, which both neighbour Minas.

It is not clear what has caused the rise in cases.

New Technology Lets Diabetics Skip Multiple Finger Pricks

One of the biggest complaints for diabetics is that they hate having to prick their fingers multiple times to test sugar levels throughout the day. But now, there’s new technology that’s changing that.

The Food and Drug Administration A has approved the Dexcom G5 continuous glucose monitoring system (CGM). Instead of multiple finger pricks to track your blood sugar levels, you will only need two per day.

Here’s how the Dexcom G5 works:

A sensor is attached to a transmitter, which is placed under your skin on the abdomen. The device lasts for about a week and then is removed and replaced.

Glucose data is sent via Bluetooth to a smartphone app to update your insulin levels for up to 12 hours. Users can get up to 288 readings per day.

The system is available now and is covered by many insurance companies.

Asthma May Be Misdiagnosed In Many Adults

As many as one in three adults diagnosed with asthma may not actually have the chronic lung disorder, a Canadian study suggests.

Researchers did lung function tests on 613 adults who had been diagnosed with asthma within the past five years. If participants took asthma medicines, researchers gradually weaned them off the drugs over four clinic visits to see how well their lungs worked without treatment.

The evaluations ruled out asthma in 203 of the participants, or 33 percent. After one year of follow-up, 181 of these people still did too well on lung tests to be diagnosed with asthma, researchers report in JAMA.

“We were able to get these patients completely off asthma medications, and they did well in follow up over the next year despite remaining off medications,” said lead study author Dr. Shawn Aaron of the University of Ottawa and the Ottawa Hospital Research Institute.

“Some of these patients were clearly misdiagnosed to begin with, and they had other conditions other than asthma, and some did have asthma but it was in remission,” Aaron added by email.

Asthma can be difficult to diagnose because not all patients have the same triggers or symptoms, which can include difficulty breathing, chest pain, cough and wheezing. Some chronic asthma patients experience periods of remission and relapse.

For the current study, researchers had all of the patients monitor symptoms and do breathing tests at home to see how fast air comes out of their lungs, a measurement known as peak expiratory flow.

All of the participants also did bronchial challenge tests. For these assessments, patients inhaled a medication that causes the bronchial tubes to constrict, simulating conditions that can cause asthma to see how well airways react.

Each patient also did spirometry tests that measure lung function by seeing how much air people inhale, how much they exhale and how fast they exhale.

Participants in whom a diagnosis of current asthma was ultimately ruled out were followed up clinically with repeated bronchial challenge tests over one year.

Among those misdiagnosed with asthma, 12 people, or 2 percent of the participants, had serious conditions other than asthma, like heart disease and pulmonary hypertension, the study found. Still others were found to have conditions like chronic obstructive pulmonary disease (COPD), gastroesophageal reflux (GERD) or anxiety-related hyperventilation rather than asthma.

Those who were misdiagnosed were less likely to have had airflow limitation tests when they were originally diagnosed, compared with participants who had their original asthma diagnosis confirmed in the current study.

For patients who had asthma ruled out, 90 percent had asthma medications safely stopped for one year after being weaned off drugs for the study.

One limitation of the study is that researchers only followed patients for a total of 15 months, which isn’t long enough to rule out the possibility that some patients in remission might have asthma symptoms in the future, the authors note. The study also excluded patients using long-term oral corticosteroids, leaving only people with milder forms of asthma to participated.

Still, the study reaffirms the need for patients who have been diagnosed with asthma to have their diagnosis confirmed with objective lung function testing, particularly spirometry, before being started on lifelong therapy, Dr. Alan Kaplan, a researcher at the University of Toronto who wasn’t involved in the study, said by email.

“The most important potential harm of misdiagnosis of asthma is not treating the patient’s actual disease,” said Dr. Helen Hollingsworth of Boston University, co-author of an accompanying editorial.

“For other patients, not recognizing that asthma is in remission, can lead to taking unnecessary medication,” Hollingsworth added by email. “While the adverse effects of asthma medication are minimal, no one wants to take unnecessary medication.”

Stem Cells Could Restore Vision After Eye Disease

A new technique using stem cells can restore vision in mice that have end-stage eye disease, a condition that is thought to bring irreversible vision loss.

Researchers used stem cells to grow new retina tissue in a lab, and then transplanted that tissue into mice that had end-stage retinal degeneration. More than 40 percent of the mice gained the ability to see light as the result of the procedure, the researchers said.

This is the first time researchers have successfully transplanted the cells that sense light, the retina’s light receptors, so that these cells connect to the host’s nervous system and send signals to the host’s brain, the researchers said.

“We were at first very excited to see that the transplants do robustly respond to light,” Dr. Michiko Mandai, the first author of the paper and a deputy project leader at the RIKEN Center for Developmental Biology in Japan, told Live Science.

The researchers hope to eventually increase the number of connections between the cells in the host’s degenerated retina and the stem cell transplants, Mandai said. This could allow the mice to see not only light, but also a large figure or movement, Mandai said.

The retina is the layer of tissue at the back of the eye that actually senses light and passes signals on to the brain, where the information is processed and an image is perceived . In individuals with retinal degeneration, the light-sensing cells are gradually lost, eventually leading to total blindness, Mandai said. Age-related macular degeneration , the most prevalent type of retinal degeneration, affects approximately 15 million people in the U.S. and 170 million people worldwide.

In the study, researchers converted skin cells from an adult mouse into mouse induced pluripotent stem cells (iPSCs). The scientists then converted these stem cells into retinal tissue and transplanted the tissue into mice that had end-stage retinal degeneration.

The researchers used what is called a shuttle avoidance test to determine whether the mice could see light. The test involves a sound- and light-insulated box with two chambers, separated by a wall with a small opening that allows mice to move between the two compartments.

A mouse is placed in the box and trained to recognize that a simultaneous beep and light signal is a warning of an electric shock. The mouse can avoid the shock by moving to the other chamber. In the study, once the mice were trained to avoid the shock, only the light (and not the beep) was used as a warning, to test whether the mouse could see the light.

In the experiment, after retinal transplantation , four of 10 mice with transplants in both eyes, and five of 11 mice with a transplant in only one eye, could respond to the light signal, according to the findings, published Jan. 10 in the journal Stem Cell Reports.

It is unclear whether the new technique could be applied in humans, and testing it is likely a long way off, the researchers said. One aspect of human health to consider is that, whereas the mice in this experiment were able to respond to light one month after the retina transplantation, the human retina takes a longer time to mature, the researchers said in a statement . Thus, it may take up to five or six months for a transplanted retina in humans to start responding to light, they said.

Furthermore, researchers still need to test whether the same procedure would work in humans, the scientists said.

“From a clinical point of view, although we think that these results are very promising, human eyes may have a different environment from mice, and [the questions of] whether they accept retinal transplants and make connections with transplants are yet to be tested,” Mandai told Live Science. “We would get the answers only in [a] human study.”

Cancer Spread Cut By 75% In Tests

The deadly spread of cancer around the body has been cut by three-quarters in animal experiments, say scientists.

Tumours can “seed” themselves elsewhere in the body and this process is behind 90% of cancer deaths.

The mouse study, published in Nature, showed altering the immune system slowed the spread of skin cancers to the lungs.

Cancer Research UK said the early work gave new insight into how tumours spread and may lead to new treatments.

The spread of cancer – known as metastasis – is a fight between a rapidly mutating cancer and the rest of the body.

The team at the Sanger Institute in Cambridge was trying to figure out what affected tumour spread in the body.

Researchers created 810 sets of genetically modified lab mice to discover which sections of the DNA were involved in the body resisting a cancer’s spread.

The animals were injected with melanomas (skin cancer) and the team counted the number of tumours that formed in the lung.

Their hunt led them to discover 23 sections of DNA, or genes, that made it either easier or harder for a cancer to spread.

Many of them were involved in controlling the immune system.

Targeting one gene – called Spns2 – led to a three-quarters reduction in tumours spreading to the lungs.

‘Interesting biology’

“It regulated the balance of immune cells within the lung,” Dr David Adams, one of the team, told the BBC News website.

“It changes the balance of cells that play a role in killing tumour cells and those that switch off the immune system.”

The field of immunotherapy – harnessing the power of the immune system to fight cancer – has delivered dramatic results for some patients.

A rare few with a terminal diagnosis have seen all signs of cancer disappear from their body, although the drugs still fail to work in many patients.

Dr Adams said: “We’ve learnt some interesting new biology that we might be able to use – it’s told us this gene is involved in tumour growth.”

Drugs that target Spns2 could produce the same cancer-slowing effect but that remains a distant prospect.

Dr Justine Alford, from Cancer Research UK, said: “This study in mice gives a new insight into the genes that play a role in cancer spreading and may highlight a potential way to treat cancer in the future.

“Cancer that has spread is tough to treat, so research such as this is vital in the search for ways to tackle this process.”