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"content": "\u003cp>SACRAMENTO, Calif. (AP) — Supporters of an effort to repeal California's new law requiring mandatory vaccines for schoolchildren faced a Monday deadline to turn in enough signatures to qualify a ballot initiative asking voters to repeal the law.\u003c/p>\n\u003cp>The group had until the end of the day to submit the needed 366,000 signatures to county clerks to ask California voters to repeal SB277, which struck down the state's personal belief exemption for immunizations, a move that requires nearly all public schoolchildren to be vaccinated.\u003c/p>\n\u003cp>Gov. Jerry Brown signed SB277 into law earlier this year amid fierce opposition from some parents rights groups who argue the state should not force their children to be vaccinated. He said the science is clear that vaccines \"dramatically protect children against a number of infectious and dangerous diseases.\"\u003c/p>\n\u003cp>It's unclear whether supporters have enough signatures to make it to the ballot and it might not be known until next week, when clerks face a deadline to report how many signatures they received. The leading proponent of the effort, former Republican Assemblyman Tim Donnelly, said in an email Monday that volunteers were coerced and threatened while collecting signatures.\u003c/p>\n\u003cp>Donnelly did not return repeated messages inquiring about the effort's chances, but said in his email that he was proud of the volunteers who worked on the campaign \"whatever the outcome is.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"The SB277 Referendum was sabotaged from without and within by powerful forces from its very inception, but we never gave up and we never gave in,\" he wrote.\u003c/p>\n\u003cp>The bill's author, Sen. Richard Pan, D-Sacramento, told reporters Monday that he's confident voters support the vaccination requirement, whether the initiative makes the ballot or not.\u003c/p>\n\u003cp>\"I'm sure the voters of California are not interested in letting a privileged few take away the rights of all Californians to be safe from preventable disease,\" Pan said. \"If they don't have the signatures, I think it would be a direct reflection of the fact that Californians wanted to see their communities safe.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>California will join Mississippi and West Virginia as the only states with such strict requirements, if the law takes effect as planned next year.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>SACRAMENTO, Calif. (AP) — Supporters of an effort to repeal California's new law requiring mandatory vaccines for schoolchildren faced a Monday deadline to turn in enough signatures to qualify a ballot initiative asking voters to repeal the law.\u003c/p>\n\u003cp>The group had until the end of the day to submit the needed 366,000 signatures to county clerks to ask California voters to repeal SB277, which struck down the state's personal belief exemption for immunizations, a move that requires nearly all public schoolchildren to be vaccinated.\u003c/p>\n\u003cp>Gov. Jerry Brown signed SB277 into law earlier this year amid fierce opposition from some parents rights groups who argue the state should not force their children to be vaccinated. He said the science is clear that vaccines \"dramatically protect children against a number of infectious and dangerous diseases.\"\u003c/p>\n\u003cp>It's unclear whether supporters have enough signatures to make it to the ballot and it might not be known until next week, when clerks face a deadline to report how many signatures they received. The leading proponent of the effort, former Republican Assemblyman Tim Donnelly, said in an email Monday that volunteers were coerced and threatened while collecting signatures.\u003c/p>\n\u003cp>Donnelly did not return repeated messages inquiring about the effort's chances, but said in his email that he was proud of the volunteers who worked on the campaign \"whatever the outcome is.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"The SB277 Referendum was sabotaged from without and within by powerful forces from its very inception, but we never gave up and we never gave in,\" he wrote.\u003c/p>\n\u003cp>The bill's author, Sen. Richard Pan, D-Sacramento, told reporters Monday that he's confident voters support the vaccination requirement, whether the initiative makes the ballot or not.\u003c/p>\n\u003cp>\"I'm sure the voters of California are not interested in letting a privileged few take away the rights of all Californians to be safe from preventable disease,\" Pan said. \"If they don't have the signatures, I think it would be a direct reflection of the fact that Californians wanted to see their communities safe.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>California will join Mississippi and West Virginia as the only states with such strict requirements, if the law takes effect as planned next year.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Certain complications during pregnancy may increase a woman's risk of dying from heart disease later in life, according to a new analysis.\u003c/p>\n\u003cp>That increased risk can be dramatic, more than 7-fold, if a woman experiences combinations of problems.\u003c/p>\n\u003cp>The analysis is from Oakland's Public Health Institute and was \u003ca href=\"http://circ.ahajournals.org/content/early/2015/09/14/CIRCULATIONAHA.113.003901.abstract?sid=07de4322-6ada-4d01-9f5b-513f74251791\" target=\"_blank\">published Monday\u003c/a> in the American Heart Association journal, Circulation.\u003c/p>\n\u003cp>Heart disease is the number one killer of women in America, responsible for \u003ca href=\"http://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_women_heart.htm\" target=\"_blank\">one in every four deaths\u003c/a> among women, according to the Centers for Disease Control.\u003c/p>\n\u003cp>While doctors have long known that pregnancy puts real stress on a woman's cardiovascular system, this study confirms and quantifies some known risks and identifies new ones.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The women followed and assessed were part of a unique group of more than 15,000 pregnant women who enrolled in the Oakland metropolitan area Child Health and Development Studies between 1959 and 1967. Researchers have been following these women for decades since.\u003c/p>\n\u003cp>The 7.1 times increased risk of death from heart disease happened in women who had pre-pregnancy or early-pregnancy high blood pressure in combination with a pre-term delivery of the baby.\u003c/p>\n\u003cp>If a woman had pre-existing high blood pressure and\u003ca href=\"http://www.webmd.com/baby/guide/preeclampsia-eclampsia\" target=\"_blank\"> pre-eclampsia\u003c/a>, which is characterized by high blood pressure after 20 weeks of pregnancy and protein in the urine, her risk of later heart disease death increased 5.6 times.\u003c/p>\n\u003cp>Senior author Barbara Cohn with Oakland's Public Health Institute said she was surprised by the some of the findings.\u003c/p>\n\u003cp>\"Knowing additional information about the combinations of complications ... led to higher risk of cardiovascular disease than we expected.\u003c/p>\n\u003cp>Cohn and her colleagues also identified statistically significant differences for African-American women. They made up 22 percent of the enrollees in the study, but were 1.7 times more likely to die of heart disease, if they developed high blood pressure after 20 weeks of pregnancy. Women in other ethnic groups -- Hispanic, Asian, and Caucasian -- did not appear to be at significant increased risk from this development.\u003c/p>\n\u003cp>Cohn argued that doctors could save lives simply by taking a woman's pregnancy history.\u003c/p>\n\u003cp>\"If she has had these complications, (doctors) can begin surveillance early, recommend prevention measures that the patient can take to address factors they can control,\" Cohn said. \"It's really not expensive to get this history. It doesn't require an intervention like a blood test or a special medical test.\u003c/p>\n\u003cp>UC San Francisco professor Dr. Rita Redberg, who directs women's cardiovascular services, was not involved in the study. In an interview with \u003ca href=\"http://consumer.healthday.com/cardiovascular-health-information-20/misc-stroke-related-heart-news-360/complicated-pregnancy-linked-to-later-heart-disease-703466.html\" target=\"_blank\">HealthDay \u003c/a>she said that the study reveals an opportunity to identify the at-risk population at a younger age.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"Obviously, we're catching women younger when we're doing it during pregnancy,\" Redberg said. \"While it's never too late, we like to start young.\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Certain complications during pregnancy may increase a woman's risk of dying from heart disease later in life, according to a new analysis.\u003c/p>\n\u003cp>That increased risk can be dramatic, more than 7-fold, if a woman experiences combinations of problems.\u003c/p>\n\u003cp>The analysis is from Oakland's Public Health Institute and was \u003ca href=\"http://circ.ahajournals.org/content/early/2015/09/14/CIRCULATIONAHA.113.003901.abstract?sid=07de4322-6ada-4d01-9f5b-513f74251791\" target=\"_blank\">published Monday\u003c/a> in the American Heart Association journal, Circulation.\u003c/p>\n\u003cp>Heart disease is the number one killer of women in America, responsible for \u003ca href=\"http://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_women_heart.htm\" target=\"_blank\">one in every four deaths\u003c/a> among women, according to the Centers for Disease Control.\u003c/p>\n\u003cp>While doctors have long known that pregnancy puts real stress on a woman's cardiovascular system, this study confirms and quantifies some known risks and identifies new ones.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The women followed and assessed were part of a unique group of more than 15,000 pregnant women who enrolled in the Oakland metropolitan area Child Health and Development Studies between 1959 and 1967. Researchers have been following these women for decades since.\u003c/p>\n\u003cp>The 7.1 times increased risk of death from heart disease happened in women who had pre-pregnancy or early-pregnancy high blood pressure in combination with a pre-term delivery of the baby.\u003c/p>\n\u003cp>If a woman had pre-existing high blood pressure and\u003ca href=\"http://www.webmd.com/baby/guide/preeclampsia-eclampsia\" target=\"_blank\"> pre-eclampsia\u003c/a>, which is characterized by high blood pressure after 20 weeks of pregnancy and protein in the urine, her risk of later heart disease death increased 5.6 times.\u003c/p>\n\u003cp>Senior author Barbara Cohn with Oakland's Public Health Institute said she was surprised by the some of the findings.\u003c/p>\n\u003cp>\"Knowing additional information about the combinations of complications ... led to higher risk of cardiovascular disease than we expected.\u003c/p>\n\u003cp>Cohn and her colleagues also identified statistically significant differences for African-American women. They made up 22 percent of the enrollees in the study, but were 1.7 times more likely to die of heart disease, if they developed high blood pressure after 20 weeks of pregnancy. Women in other ethnic groups -- Hispanic, Asian, and Caucasian -- did not appear to be at significant increased risk from this development.\u003c/p>\n\u003cp>Cohn argued that doctors could save lives simply by taking a woman's pregnancy history.\u003c/p>\n\u003cp>\"If she has had these complications, (doctors) can begin surveillance early, recommend prevention measures that the patient can take to address factors they can control,\" Cohn said. \"It's really not expensive to get this history. It doesn't require an intervention like a blood test or a special medical test.\u003c/p>\n\u003cp>UC San Francisco professor Dr. Rita Redberg, who directs women's cardiovascular services, was not involved in the study. In an interview with \u003ca href=\"http://consumer.healthday.com/cardiovascular-health-information-20/misc-stroke-related-heart-news-360/complicated-pregnancy-linked-to-later-heart-disease-703466.html\" target=\"_blank\">HealthDay \u003c/a>she said that the study reveals an opportunity to identify the at-risk population at a younger age.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"Obviously, we're catching women younger when we're doing it during pregnancy,\" Redberg said. \"While it's never too late, we like to start young.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Do You Really Need Antimicrobials In Your Soap?",
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"content": "\u003cp>With school in full swing and flu season just around the corner, you might be looking for a way to keep those germs at bay. But if you're stocking up on antibacterial soaps, a study suggests you might as well be reaching for that regular old bar of soap instead.\u003c/p>\n\u003cp>Korean scientists found that antibacterial soap with the active ingredient triclosan was \"no more effective than plain soap at reducing bacterial contamination when used under 'real-life' conditions,\" according to a \u003ca href=\"http://www.oxfordjournals.org/our_journals/jac/press_releases/prpaper.pdf\" target=\"_blank\">study\u003c/a> published in the \u003cem>Journal of Antimicrobial Chemotherapy\u003c/em> this week.\u003c/p>\n\u003cp>Yet Brian Sansoni, a spokesman for the trade organization that represents makers of household cleaning products, calls the study \"kind of irrelevant.\" That's because Sansoni says companies are increasingly switching to other ingredients in place of triclosan, which has been criticized for potentially causing a variety of health issues, from antibiotic resistance to endocrine disruption.\u003c/p>\n\u003cp>The study \"talks about one specific ingredient that really is not being used in much of the mass-market antibacterial soaps anymore,\" says Sansoni, vice president of communication and membership for the American Cleaning Institute.\u003c/p>\n\u003cp>It's not clear how many antibacterial products still contain triclosan. A quick scan of the Internet finds a host of websites that list products containing it. But a closer look at some of the products shows that triclosan has been substituted for another antimicrobial ingredient. For example, \u003ca href=\"http://www.dialsoap.com/products/original-antibacterial-foaming-hand-wash\" target=\"_blank\">Dial Complete Antibacterial Hand Wash\u003c/a> comes up in many searches for triclosan, despite the fact that it now contains benzethonium chloride.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Triclosan can still be found in some personal care items, like Cetaphil's Gentle Cleansing Antibacterial Bar, Colgate Total toothpaste, CVS Antibacterial Hand Soap and Dawn Ultra Antibacterial Dishwashing Liquid.\u003c/p>\n\u003cp>Procter & Gamble, the maker of Dawn, states \u003ca href=\"http://us.pg.com/our_brands/product_safety/ingredient_safety/triclosan\" target=\"_blank\">on its webpage\u003c/a> that the company has removed triclosan from more than 99 percent of the products where it had been used and has \"an exit plan for the few remaining uses.\"\u003c/p>\n\u003cp>While Sansoni couldn't specify exactly why makers of antibacterial products are switching to other active ingredients, he says that the companies didn't ditch triclosan due to safety issues. Antibacterial soaps and washes have a long history of safety and effectiveness, he says, backed by scientific data and research.\u003c/p>\n\u003cp>But the Food and Drug Administration's consumer information \u003ca href=\"http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm205999.htm\" target=\"_blank\">page on triclosan\u003c/a> is a little less definite. \"Triclosan is not currently known to be hazardous to humans,\" the page reads. \"But several scientific studies have come out since the last time FDA reviewed this ingredient that merit further review,\" including animal studies indicating that triclosan alters hormone regulation and other studies suggesting that triclosan contributes to bacteria becoming resistant to antibiotics used for medical treatments. A \u003ca href=\"http://www.pnas.org/content/111/48/17200.full.pdf+html\">study\u003c/a> published last year by the journal \u003cem>Proceedings of the National Academy of Sciences\u003c/em> found that triclosan promotes liver tumors in mice.\u003c/p>\n\u003cp>Almost two years ago, the Food and Drug Administration issued a \u003ca href=\"http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm378542.htm\" target=\"_blank\">proposed rule\u003c/a> that would require antibacterial soap manufacturers to show that the soaps and body washes are \"safe for long-term daily use and more effective than plain soap and water in preventing illness and the spread of certain infections.\" The rule would apply to all antibacterial soap products, not just those with the ingredient triclosan.\u003c/p>\n\u003cp>An FDA spokesperson said via email that antibacterial soap products are allowed to stay on shelves for now, and that the FDA expects to issue a final ruling by this time next year.\u003c/p>\n\u003cp>Regardless of the controversy over its safety, there's also the question of whether triclosan is better at tackling germs than plain old soap and water. The authors of this latest study, who are from Korea University in Seoul, compared the effects of regular soap and antibacterial soap on 20 strains of bacteria.\u003c/p>\n\u003cp>They found no significant difference between the two soaps in combating bacteria in the short time frame typical for hand washing. The antibacterial soap had a greater bacteria-fighting effect than regular soap when applied for nine hours – long after we've stopped washing our hands.\u003c/p>\n\u003cp>\"This study shows that presence of antiseptic ingredients – in this case, triclosan – in soap does not always guarantee higher antimicrobial efficacy during hand washing,\" Min Suk Rhee, a professor in the department of biotechnology and one of the study's authors, says in an email. \"If the manufacturer would like to advertise antiseptic efficacy of their products, they should supply scientific evidence to support the claims.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>In fact, \u003ca href=\"http://www.npr.org/sections/health-shots/2015/02/23/387766821/there-s-bacteria-in-your-soap-and-everywhere-else\" target=\"_blank\">all soap contains bacteria\u003c/a>, as we noted earlier this year. Manufacturers are required to keep the germs down to a certain level, which they do with antimicrobial agents, even if the product isn't labeled as such.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Do+You+Really+Need+Antimicrobials+In+Your+Soap%3F+&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>With school in full swing and flu season just around the corner, you might be looking for a way to keep those germs at bay. But if you're stocking up on antibacterial soaps, a study suggests you might as well be reaching for that regular old bar of soap instead.\u003c/p>\n\u003cp>Korean scientists found that antibacterial soap with the active ingredient triclosan was \"no more effective than plain soap at reducing bacterial contamination when used under 'real-life' conditions,\" according to a \u003ca href=\"http://www.oxfordjournals.org/our_journals/jac/press_releases/prpaper.pdf\" target=\"_blank\">study\u003c/a> published in the \u003cem>Journal of Antimicrobial Chemotherapy\u003c/em> this week.\u003c/p>\n\u003cp>Yet Brian Sansoni, a spokesman for the trade organization that represents makers of household cleaning products, calls the study \"kind of irrelevant.\" That's because Sansoni says companies are increasingly switching to other ingredients in place of triclosan, which has been criticized for potentially causing a variety of health issues, from antibiotic resistance to endocrine disruption.\u003c/p>\n\u003cp>The study \"talks about one specific ingredient that really is not being used in much of the mass-market antibacterial soaps anymore,\" says Sansoni, vice president of communication and membership for the American Cleaning Institute.\u003c/p>\n\u003cp>It's not clear how many antibacterial products still contain triclosan. A quick scan of the Internet finds a host of websites that list products containing it. But a closer look at some of the products shows that triclosan has been substituted for another antimicrobial ingredient. For example, \u003ca href=\"http://www.dialsoap.com/products/original-antibacterial-foaming-hand-wash\" target=\"_blank\">Dial Complete Antibacterial Hand Wash\u003c/a> comes up in many searches for triclosan, despite the fact that it now contains benzethonium chloride.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Triclosan can still be found in some personal care items, like Cetaphil's Gentle Cleansing Antibacterial Bar, Colgate Total toothpaste, CVS Antibacterial Hand Soap and Dawn Ultra Antibacterial Dishwashing Liquid.\u003c/p>\n\u003cp>Procter & Gamble, the maker of Dawn, states \u003ca href=\"http://us.pg.com/our_brands/product_safety/ingredient_safety/triclosan\" target=\"_blank\">on its webpage\u003c/a> that the company has removed triclosan from more than 99 percent of the products where it had been used and has \"an exit plan for the few remaining uses.\"\u003c/p>\n\u003cp>While Sansoni couldn't specify exactly why makers of antibacterial products are switching to other active ingredients, he says that the companies didn't ditch triclosan due to safety issues. Antibacterial soaps and washes have a long history of safety and effectiveness, he says, backed by scientific data and research.\u003c/p>\n\u003cp>But the Food and Drug Administration's consumer information \u003ca href=\"http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm205999.htm\" target=\"_blank\">page on triclosan\u003c/a> is a little less definite. \"Triclosan is not currently known to be hazardous to humans,\" the page reads. \"But several scientific studies have come out since the last time FDA reviewed this ingredient that merit further review,\" including animal studies indicating that triclosan alters hormone regulation and other studies suggesting that triclosan contributes to bacteria becoming resistant to antibiotics used for medical treatments. A \u003ca href=\"http://www.pnas.org/content/111/48/17200.full.pdf+html\">study\u003c/a> published last year by the journal \u003cem>Proceedings of the National Academy of Sciences\u003c/em> found that triclosan promotes liver tumors in mice.\u003c/p>\n\u003cp>Almost two years ago, the Food and Drug Administration issued a \u003ca href=\"http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm378542.htm\" target=\"_blank\">proposed rule\u003c/a> that would require antibacterial soap manufacturers to show that the soaps and body washes are \"safe for long-term daily use and more effective than plain soap and water in preventing illness and the spread of certain infections.\" The rule would apply to all antibacterial soap products, not just those with the ingredient triclosan.\u003c/p>\n\u003cp>An FDA spokesperson said via email that antibacterial soap products are allowed to stay on shelves for now, and that the FDA expects to issue a final ruling by this time next year.\u003c/p>\n\u003cp>Regardless of the controversy over its safety, there's also the question of whether triclosan is better at tackling germs than plain old soap and water. The authors of this latest study, who are from Korea University in Seoul, compared the effects of regular soap and antibacterial soap on 20 strains of bacteria.\u003c/p>\n\u003cp>They found no significant difference between the two soaps in combating bacteria in the short time frame typical for hand washing. The antibacterial soap had a greater bacteria-fighting effect than regular soap when applied for nine hours – long after we've stopped washing our hands.\u003c/p>\n\u003cp>\"This study shows that presence of antiseptic ingredients – in this case, triclosan – in soap does not always guarantee higher antimicrobial efficacy during hand washing,\" Min Suk Rhee, a professor in the department of biotechnology and one of the study's authors, says in an email. \"If the manufacturer would like to advertise antiseptic efficacy of their products, they should supply scientific evidence to support the claims.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>In fact, \u003ca href=\"http://www.npr.org/sections/health-shots/2015/02/23/387766821/there-s-bacteria-in-your-soap-and-everywhere-else\" target=\"_blank\">all soap contains bacteria\u003c/a>, as we noted earlier this year. Manufacturers are required to keep the germs down to a certain level, which they do with antimicrobial agents, even if the product isn't labeled as such.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Do+You+Really+Need+Antimicrobials+In+Your+Soap%3F+&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Why Trump, Paul Are Wrong -- 'No Alternative Vaccine Schedule'",
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"content": "\u003cp>Donald Trump likely wrecked the day of vaccine experts across the country in\u003ca href=\"http://ww2.kqed.org/news/2015/09/17/fiorina-seen-as-big-winner-in-debate\" target=\"_blank\"> last night's Republican debate.\u003c/a> Trump reiterated his opinion that vaccines cause autism, a belief that has been thoroughly debunked by\u003ca href=\"https://www2.aap.org/immunization/families/faq/vaccinestudies.pdf\" target=\"_blank\"> repeated studies.\u003c/a>\u003c/p>\n\u003cp>Candidate Ben Carson, a retired neurosurgeon, did refute Trump, saying, \"We have extremely well-documented proof that there's no autism associated with vaccinations.\" The Autism Self Advocacy Network also pointed to the \"wealth of scientific evidence debunking any link between autism and vaccinations,\" in its\u003ca href=\"http://autisticadvocacy.org/2015/09/asan-statement-on-gop-primary-debate-comments-on-autism-and-vaccination/\" target=\"_blank\"> own statement\u003c/a>.\u003c/p>\n\u003cp>Then pretty quickly, the discussion morphed into a challenge of the vaccine schedule itself. Worse, it started with Sen. Rand Paul, who is a physician, an ophthalmologist, and said he was for vaccines but also \"for freedom.\" He suggested spacing out vaccines.\u003c/p>\n\u003cp>Trump essentially said the same thing. “I’m in favor of vaccines,\" he said, then added the caveat: \"Do them over a longer period of time, same amount, ... But just in little sections.”\u003c/p>\n\u003cp>[contextly_sidebar id=\"O8p9ZQtXNTAMRJgH7Um67yJk3kMEayZM\"]The American Academy of Pediatrics is trying to set the record straight: \"There is no 'alternative' immunization schedule,\" Dr. Karen Remley, executive director of the group \u003ca href=\"https://www.aap.org/en-us/about-the-aap/aap-press-room/pages/American-Academy-of-Pediatrics-Reiterates-Safety-and-Importance-of-Vaccines.aspx\" target=\"_blank\">said in a statement\u003c/a>. \"Delaying vaccines only leaves a child at risk of disease for a longer period of time; it does not make vaccinating safer.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The Centers for Disease Control\u003ca href=\"http://www.cdc.gov/vaccines/parents/downloads/parent-ver-sch-0-6yrs.pdf\" target=\"_blank\"> recommends \u003c/a>vaccinating against 14 diseases, beginning at birth.\u003c/p>\n\u003cp>Dr. Paul Offit, who directs the Vaccine Education Center at Children's Hospital of Philadelphia, is one of the vaccine experts who is now spending a chunk of his day countering Trump's assertions.\u003c/p>\n\u003cp>Yes, 100 years ago, there was just one vaccine available -- smallpox. Today, there are far more. But the overall challenge to the immune system is actually smaller today, Offit says.\u003c/p>\n\u003cp>\"The number of immunological components in vaccines today is fewer than the one vaccine we got a hundred years ago,\" he said.\u003c/p>\n\u003cp>Beyond vaccines, simply living outside the womb's sterile environment, Offit says, makes your immune system work harder than today's vaccines do.\u003c/p>\n\u003cp>\"When you leave the womb,\" he said, \"very quickly you have living on the surface of your body trillions of bacteria to which you make an immune response.\"\u003c/p>\n\u003cp>\"You're always exposed to a whole wealth of immune challenges, every day, that are far greater than what you get from vaccines,\" he added.\u003c/p>\n\u003cp>Dr. Art Reingold, a professor of public health at UC Berkeley, also vouched for the safety of the schedule. \"We know we are not overwhelming the infant's immune system, that the infant on a daily basis sees more antigens just in terms of interacting with the environment and crawling around, than from vaccines.\"\u003c/p>\n\u003cp>The vaccine schedule is well-tested, Offit says, and new vaccines are not added randomly. \"You can't put a vaccine onto the existing schedule without proving that that vaccine doesn't interfere with the safety profile of existing vaccines.\"\u003c/p>\n\u003cp>So, when Donald Trump suggests that vaccines can be spaced out?\u003c/p>\n\u003cp>He's \"arguing for a schedule that's untested.\"\u003c/p>\n\u003cp>While delaying vaccines puts children at risk of contracting disease, as the American Academy of Pediatrics' Remley noted, it's unclear how great that delay would be for specific shots.\u003c/p>\n\u003cp>\"It would depend on which disease and how common it is,\" Reingold said and would be hard to quantify.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>But delaying vaccines might be the only way some parents will consent to vaccinating their child in the first place. \"There are providers who might say ... 'I'm willing to work with you on that,' \" Reingold speculated, while noting that he does not see patients himself. \"I'm sure those are difficult discussions between parents and providers.\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Donald Trump likely wrecked the day of vaccine experts across the country in\u003ca href=\"http://ww2.kqed.org/news/2015/09/17/fiorina-seen-as-big-winner-in-debate\" target=\"_blank\"> last night's Republican debate.\u003c/a> Trump reiterated his opinion that vaccines cause autism, a belief that has been thoroughly debunked by\u003ca href=\"https://www2.aap.org/immunization/families/faq/vaccinestudies.pdf\" target=\"_blank\"> repeated studies.\u003c/a>\u003c/p>\n\u003cp>Candidate Ben Carson, a retired neurosurgeon, did refute Trump, saying, \"We have extremely well-documented proof that there's no autism associated with vaccinations.\" The Autism Self Advocacy Network also pointed to the \"wealth of scientific evidence debunking any link between autism and vaccinations,\" in its\u003ca href=\"http://autisticadvocacy.org/2015/09/asan-statement-on-gop-primary-debate-comments-on-autism-and-vaccination/\" target=\"_blank\"> own statement\u003c/a>.\u003c/p>\n\u003cp>Then pretty quickly, the discussion morphed into a challenge of the vaccine schedule itself. Worse, it started with Sen. Rand Paul, who is a physician, an ophthalmologist, and said he was for vaccines but also \"for freedom.\" He suggested spacing out vaccines.\u003c/p>\n\u003cp>Trump essentially said the same thing. “I’m in favor of vaccines,\" he said, then added the caveat: \"Do them over a longer period of time, same amount, ... But just in little sections.”\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>The American Academy of Pediatrics is trying to set the record straight: \"There is no 'alternative' immunization schedule,\" Dr. Karen Remley, executive director of the group \u003ca href=\"https://www.aap.org/en-us/about-the-aap/aap-press-room/pages/American-Academy-of-Pediatrics-Reiterates-Safety-and-Importance-of-Vaccines.aspx\" target=\"_blank\">said in a statement\u003c/a>. \"Delaying vaccines only leaves a child at risk of disease for a longer period of time; it does not make vaccinating safer.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The Centers for Disease Control\u003ca href=\"http://www.cdc.gov/vaccines/parents/downloads/parent-ver-sch-0-6yrs.pdf\" target=\"_blank\"> recommends \u003c/a>vaccinating against 14 diseases, beginning at birth.\u003c/p>\n\u003cp>Dr. Paul Offit, who directs the Vaccine Education Center at Children's Hospital of Philadelphia, is one of the vaccine experts who is now spending a chunk of his day countering Trump's assertions.\u003c/p>\n\u003cp>Yes, 100 years ago, there was just one vaccine available -- smallpox. Today, there are far more. But the overall challenge to the immune system is actually smaller today, Offit says.\u003c/p>\n\u003cp>\"The number of immunological components in vaccines today is fewer than the one vaccine we got a hundred years ago,\" he said.\u003c/p>\n\u003cp>Beyond vaccines, simply living outside the womb's sterile environment, Offit says, makes your immune system work harder than today's vaccines do.\u003c/p>\n\u003cp>\"When you leave the womb,\" he said, \"very quickly you have living on the surface of your body trillions of bacteria to which you make an immune response.\"\u003c/p>\n\u003cp>\"You're always exposed to a whole wealth of immune challenges, every day, that are far greater than what you get from vaccines,\" he added.\u003c/p>\n\u003cp>Dr. Art Reingold, a professor of public health at UC Berkeley, also vouched for the safety of the schedule. \"We know we are not overwhelming the infant's immune system, that the infant on a daily basis sees more antigens just in terms of interacting with the environment and crawling around, than from vaccines.\"\u003c/p>\n\u003cp>The vaccine schedule is well-tested, Offit says, and new vaccines are not added randomly. \"You can't put a vaccine onto the existing schedule without proving that that vaccine doesn't interfere with the safety profile of existing vaccines.\"\u003c/p>\n\u003cp>So, when Donald Trump suggests that vaccines can be spaced out?\u003c/p>\n\u003cp>He's \"arguing for a schedule that's untested.\"\u003c/p>\n\u003cp>While delaying vaccines puts children at risk of contracting disease, as the American Academy of Pediatrics' Remley noted, it's unclear how great that delay would be for specific shots.\u003c/p>\n\u003cp>\"It would depend on which disease and how common it is,\" Reingold said and would be hard to quantify.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>But delaying vaccines might be the only way some parents will consent to vaccinating their child in the first place. \"There are providers who might say ... 'I'm willing to work with you on that,' \" Reingold speculated, while noting that he does not see patients himself. \"I'm sure those are difficult discussions between parents and providers.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Bill Making California Toughest in U.S. on Livestock Antibiotics Now Up to Governor",
"title": "Bill Making California Toughest in U.S. on Livestock Antibiotics Now Up to Governor",
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"content": "\u003cp>A bill that would require the most stringent regulations in the country on the use of antibiotics in livestock is on Gov. Jerry Brown's desk.\u003c/p>\n\u003cp>If signed into law, California would ban the common practice of using drugs to fatten animals and would require a prescription from a veterinarian for other uses, such as fighting disease or infection.\u003c/p>\n\u003cp>The bill, \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201520160SB27\" target=\"_blank\">SB27\u003c/a>, would effectively end over-the-counter sales of antibiotics for livestock. It also calls for monitoring by California's Department of Food and Agriculture and development of best practices for antibiotic use in livestock.\u003c/p>\n\u003cp>\"It will make California the first state in the nation to put constraints on the regular ongoing uses of antibiotics,\" said Avinash Kar, a senior attorney with the Natural Resources Defense Council, which supports the bill. \"These are all important advances, and we are hopeful that this will mean that other states will follow California's lead and, hopefully, even the federal government.”\u003c/p>\n\u003cp>More than 70 percent of the antibiotics sold in the U.S. are for animal use. Widespread use -- in people, too -- contributes to the rise of drug-resistant bacteria. (As an aside, the \"70 percent\" number is the subject of some debate, but \u003ca href=\"http://www.politifact.com/truth-o-meter/statements/2013/oct/15/louise-slaughter/rep-louise-slaughter-says-80-antibiotics-are-fed-l/\" target=\"_blank\">appears to be quite accurate\u003c/a>.)\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The Centers for Disease Control and Prevention estimates that 2 million people get sick every year with a drug-resistant infection and \u003ca href=\"http://www.cdc.gov/drugresistance/\" target=\"_blank\">23,000 die \u003c/a>as a result of those illnesses.\u003c/p>\n\u003cp>\"Massive amounts of antibiotics are used on farms in the creation of meat,\" said Elisa Odabashian, director of Consumers Union's West Coast office, which also backs the bill.\u003c/p>\n\u003cp>\"If they're used to treat a disease, like antibiotics are used to treat a disease in humans, for a limited time, we're fine with that,” she said. “It's using it for growth promotion or disease prevention that creates these adaptive superbugs that makes medicines ineffective.”\u003c/p>\n\u003cp>Both the NRDC and Consumers Union had originally opposed the bill, labeling it too weak. It was first introduced last December.\u003c/p>\n\u003cp>But in the final two weeks of the session, which ended last Friday, Odabashian and Kar say that the governor’s office got involved and pushed for a tougher bill. It was only after the bill was amended to be more stringent did the NRDC and Consumers Union drop their opposition.\u003c/p>\n\u003cp>Brown had been pushing for a tougher livestock antibiotics bill since last year, \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/10/02/why-advocates-say-browns-veto-of-livestock-antibiotics-bill-is-a-good-thing/\" target=\"_blank\">when he vetoed SB835\u003c/a>, a bill many advocates opposed \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/08/09/why-advocacy-groups-oppose-bill-limiting-use-of-antibiotics-in-animals/\" target=\"_blank\">saying it was too lax\u003c/a>. In his veto statement, Brown said he wanted state regulators to work with legislators to find “new and effective ways to reduce the unnecessary antibiotics used for livestock and poultry.”\u003c/p>\n\u003cp>Sen. Jerry Hill, D-San Mateo, is the author of both last year’s bill and this one. “I worked very closely with Gov. Brown’s administration on SB27 and I’m confident the governor will sign it,” Hill said in an email. “There is no other state that has regulations as strong as those proposed by the bill. What we are able to accomplish here in California will hopefully set the trend for the rest of the country.”\u003c/p>\n\u003cp>The governor’s office did not return a call seeking comment in time for publication.\u003c/p>\n\u003cp>Industry groups have not mounted strong opposition. California’s Farm Bureau, for example, is neutral on the bill. Noelle Cremers, its director of natural resources and commodities, said that antibiotic resistance is an issue in livestock. “We have members who are not able to use antibiotics that they used to,” she said. “So we recognize the importance of being engaged in the discussion of having antibiotics available and effective into the future.”\u003c/p>\n\u003cp>The Farm Bureau remains neutral on the bill because of its requirement of a veterinarian’s prescription for antibiotics. California will be the first state in the country to require these prescriptions. Cremers said it will be a challenge for some livestock producers in rural areas to find a veterinarian.\u003c/p>\n\u003cp>“That requirement is significant and is going to be a burden to some of our members, and that’s why we couldn’t support the bill,” she said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The governor has until early October to sign or veto the bill.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A bill that would require the most stringent regulations in the country on the use of antibiotics in livestock is on Gov. Jerry Brown's desk.\u003c/p>\n\u003cp>If signed into law, California would ban the common practice of using drugs to fatten animals and would require a prescription from a veterinarian for other uses, such as fighting disease or infection.\u003c/p>\n\u003cp>The bill, \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201520160SB27\" target=\"_blank\">SB27\u003c/a>, would effectively end over-the-counter sales of antibiotics for livestock. It also calls for monitoring by California's Department of Food and Agriculture and development of best practices for antibiotic use in livestock.\u003c/p>\n\u003cp>\"It will make California the first state in the nation to put constraints on the regular ongoing uses of antibiotics,\" said Avinash Kar, a senior attorney with the Natural Resources Defense Council, which supports the bill. \"These are all important advances, and we are hopeful that this will mean that other states will follow California's lead and, hopefully, even the federal government.”\u003c/p>\n\u003cp>More than 70 percent of the antibiotics sold in the U.S. are for animal use. Widespread use -- in people, too -- contributes to the rise of drug-resistant bacteria. (As an aside, the \"70 percent\" number is the subject of some debate, but \u003ca href=\"http://www.politifact.com/truth-o-meter/statements/2013/oct/15/louise-slaughter/rep-louise-slaughter-says-80-antibiotics-are-fed-l/\" target=\"_blank\">appears to be quite accurate\u003c/a>.)\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The Centers for Disease Control and Prevention estimates that 2 million people get sick every year with a drug-resistant infection and \u003ca href=\"http://www.cdc.gov/drugresistance/\" target=\"_blank\">23,000 die \u003c/a>as a result of those illnesses.\u003c/p>\n\u003cp>\"Massive amounts of antibiotics are used on farms in the creation of meat,\" said Elisa Odabashian, director of Consumers Union's West Coast office, which also backs the bill.\u003c/p>\n\u003cp>\"If they're used to treat a disease, like antibiotics are used to treat a disease in humans, for a limited time, we're fine with that,” she said. “It's using it for growth promotion or disease prevention that creates these adaptive superbugs that makes medicines ineffective.”\u003c/p>\n\u003cp>Both the NRDC and Consumers Union had originally opposed the bill, labeling it too weak. It was first introduced last December.\u003c/p>\n\u003cp>But in the final two weeks of the session, which ended last Friday, Odabashian and Kar say that the governor’s office got involved and pushed for a tougher bill. It was only after the bill was amended to be more stringent did the NRDC and Consumers Union drop their opposition.\u003c/p>\n\u003cp>Brown had been pushing for a tougher livestock antibiotics bill since last year, \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/10/02/why-advocates-say-browns-veto-of-livestock-antibiotics-bill-is-a-good-thing/\" target=\"_blank\">when he vetoed SB835\u003c/a>, a bill many advocates opposed \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/08/09/why-advocacy-groups-oppose-bill-limiting-use-of-antibiotics-in-animals/\" target=\"_blank\">saying it was too lax\u003c/a>. In his veto statement, Brown said he wanted state regulators to work with legislators to find “new and effective ways to reduce the unnecessary antibiotics used for livestock and poultry.”\u003c/p>\n\u003cp>Sen. Jerry Hill, D-San Mateo, is the author of both last year’s bill and this one. “I worked very closely with Gov. Brown’s administration on SB27 and I’m confident the governor will sign it,” Hill said in an email. “There is no other state that has regulations as strong as those proposed by the bill. What we are able to accomplish here in California will hopefully set the trend for the rest of the country.”\u003c/p>\n\u003cp>The governor’s office did not return a call seeking comment in time for publication.\u003c/p>\n\u003cp>Industry groups have not mounted strong opposition. California’s Farm Bureau, for example, is neutral on the bill. Noelle Cremers, its director of natural resources and commodities, said that antibiotic resistance is an issue in livestock. “We have members who are not able to use antibiotics that they used to,” she said. “So we recognize the importance of being engaged in the discussion of having antibiotics available and effective into the future.”\u003c/p>\n\u003cp>The Farm Bureau remains neutral on the bill because of its requirement of a veterinarian’s prescription for antibiotics. California will be the first state in the country to require these prescriptions. Cremers said it will be a challenge for some livestock producers in rural areas to find a veterinarian.\u003c/p>\n\u003cp>“That requirement is significant and is going to be a burden to some of our members, and that’s why we couldn’t support the bill,” she said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The governor has until early October to sign or veto the bill.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Siblings Most Common Cause of Whooping Cough Infection for Infants",
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"content": "\u003cp>Over the past decade, whooping cough has proven increasingly difficult to control. Over \u003ca href=\"http://www.cdc.gov/pertussis/fast-facts.html\" target=\"_blank\">48,000 Americans\u003c/a> caught the highly contagious bacterial disease in 2012, the most since 1955. And California experienced two epidemics that killed 13 babies in 2010 and 2014, when a total of 20,000 cases were reported.\u003c/p>\n\u003cp>Although researchers found that \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/09/30/vaccine-refusals-fueled-california-whooping-cough-epidemic-personal-belief-exemption/\" target=\"_blank\">vaccine refusal contributed \u003c/a>to the 2010 epidemic, health officials now face an even bigger problem: protection afforded by the whooping cough vaccine doesn’t last.\u003c/p>\n\u003cp>Children \u003ca href=\"http://www.cdc.gov/vaccines/hcp/vis/vis-statements/dtap.html\" target=\"_blank\">should get five doses\u003c/a> of the DTaP vaccine by age six, starting at two months, health experts say. While the vaccine is very effective in the short-term, protection begins to fade after the fifth dose, so kids need a booster when they turn 11.\u003c/p>\n\u003cp>In recent years, as evidence of the vaccine’s waning protection mounts, more and more vaccinated \u003ca href=\"http://www.cdc.gov/pertussis/surv-reporting.html\" target=\"_blank\">children and adolescents\u003c/a> are getting whooping cough, also known as pertussis.\u003c/p>\n\u003cp>Now, a study shows, these older children and adolescents have become the most common source of infection for their baby sisters and brothers.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>While doctors can identify a source of infection about half the time, the study, published Monday in the journal \u003ca href=\"http://pediatrics.aappublications.org\" target=\"_blank\">Pediatrics\u003c/a>, shows that siblings –- as young as four and a half and as old as nine –- transmitted the disease in over 35 percent of cases with mothers responsible for infecting their babies in about 20 percent of cases.\u003c/p>\n\u003cp>In the past, mothers were the most common source of infection.\u003c/p>\n\u003cp>Whooping cough causes acute spasms of coughing, which are typically followed by high-pitched “\u003ca href=\"https://www.soundsofpertussis.com/\">whoops\u003c/a>” in the struggle to breathe. Infants, especially those too young to be vaccinated, face the greatest risk of severe illness and death from pertussis, as the deadly parasite overwhelms their still developing lungs. About half of infected babies must be hospitalized.\u003c/p>\n\u003cp>For years, health officials have recommended that all pregnant women get a Tdap shot, says Tami Skoff, an epidemiologist with the Centers for Disease Control and Prevention and lead author of the study.\u003c/p>\n\u003cp>[contextly_sidebar id=\"Ez6lEliEAFWNE0XyinS8LGHEoqOaWp9H\"]“By vaccinating during pregnancy,” Skoff explains, “the mother passes protective antibodies to her baby that protect the baby against pertussis during the first few critical months of life, before the infant begins their own pertussis immunization.”\u003c/p>\n\u003cp>\u003ca href=\"http://www.nhs.uk/conditions/pregnancy-and-baby/pages/whooping-cough-vaccination-pregnant.aspx\" target=\"_blank\">Early studies\u003c/a> in the United Kingdom show that vaccinating during pregnancy is a highly effective strategy to protect infants, says Skoff.\u003c/p>\n\u003cp>After the UK program was introduced in 2012, babies whose mothers were vaccinated against pertussis at least a week before birth had a \u003ca href=\"http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60686-3/abstract\">91 percent lower risk \u003c/a>of contracting the disease than babies whose mothers did not get a shot.\u003c/p>\n\u003cp>With the shift in disease transmission from mothers to siblings, should recommendations for a booster be shifted younger than the current age of 11, if mom is expecting a baby?\u003c/p>\n\u003cp>That’s not a trivial decision, says Art Reingold, a UC Berkeley professor of public health. “Given what we know about the fairly rapid decline in vaccine-induced protection, one would want to at least model the likely effects of shifting the age for a booster.”\u003c/p>\n\u003cp>What’s more, because protection from the vaccine starts to fade from about 98 percent effectiveness to about 70 percent five years later, changing the timing of the booster could simply shift the burden of disease to other age groups, says Skoff.\u003c/p>\n\u003cp>The most effective strategy is to get all pregnant women vaccinated \u003ca href=\"http://www.cdph.ca.gov/healthinfo/discond/pages/pertussis.aspx\" target=\"_blank\">during the third trimester\u003c/a> to protect babies for the first months of life, when pertussis is most likely to cause severe, life-threatening illness, says Reingold. The next most important thing to do, he says, is to make sure young children get all their shots.\u003c/p>\n\u003cp>With an unknown source of infection for about 50 percent of cases, it’s still important for anyone who spends time with infants to be up to date on their pertussis vaccinations. Not just children, but all adults, too, including grandparents and caregivers.\u003c/p>\n\u003cp>This “\u003ca href=\"http://www.medscape.com/viewarticle/780027_2\" target=\"_blank\">cocooning\u003c/a>” strategy has been recommended since the Tdap booster was introduced in 2005. But it’s proven difficult to implement, says Reingold, in part because many adults are not inclined to get vaccinated. But even if they were, it might not matter.\u003c/p>\n\u003cp>The current “acellular” vaccine, which contains fragments of the parasite, was introduced in the late 1990s to replace the whole cell version. The whole cell vaccine afforded longer lasting protection but also caused more side effects.\u003c/p>\n\u003cp>In pertussis, the disease is caused by toxins that are released by bacteria. The pertussis vaccine protects you against those toxins, but may not prevent you from spreading the bacteria to others — and causing illness in them.\u003c/p>\n\u003cp>Already this year, California has seen \u003ca href=\"http://www.cdph.ca.gov/programs/immunize/Documents/Pertussis%2520report%25208-3-2015.pdf\" target=\"_blank\">more pertussis cases\u003c/a>, excluding the two recent epidemics, than in any year since the 1950s.\u003c/p>\n\u003cp>Public health experts would love to develop a new vaccine that is not only safe but also affords protection over the long haul. But the incentives for manufacturers to invest substantial sums in the needed research and trials are extremely limited, says Reingold. “I don’t expect a new vaccine to provide us an alternative solution in the foreseeable future.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Until then, he says, nothing offers better protection to an unvaccinated baby than being born to a recently-vaccinated mother.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Over the past decade, whooping cough has proven increasingly difficult to control. Over \u003ca href=\"http://www.cdc.gov/pertussis/fast-facts.html\" target=\"_blank\">48,000 Americans\u003c/a> caught the highly contagious bacterial disease in 2012, the most since 1955. And California experienced two epidemics that killed 13 babies in 2010 and 2014, when a total of 20,000 cases were reported.\u003c/p>\n\u003cp>Although researchers found that \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/09/30/vaccine-refusals-fueled-california-whooping-cough-epidemic-personal-belief-exemption/\" target=\"_blank\">vaccine refusal contributed \u003c/a>to the 2010 epidemic, health officials now face an even bigger problem: protection afforded by the whooping cough vaccine doesn’t last.\u003c/p>\n\u003cp>Children \u003ca href=\"http://www.cdc.gov/vaccines/hcp/vis/vis-statements/dtap.html\" target=\"_blank\">should get five doses\u003c/a> of the DTaP vaccine by age six, starting at two months, health experts say. While the vaccine is very effective in the short-term, protection begins to fade after the fifth dose, so kids need a booster when they turn 11.\u003c/p>\n\u003cp>In recent years, as evidence of the vaccine’s waning protection mounts, more and more vaccinated \u003ca href=\"http://www.cdc.gov/pertussis/surv-reporting.html\" target=\"_blank\">children and adolescents\u003c/a> are getting whooping cough, also known as pertussis.\u003c/p>\n\u003cp>Now, a study shows, these older children and adolescents have become the most common source of infection for their baby sisters and brothers.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>While doctors can identify a source of infection about half the time, the study, published Monday in the journal \u003ca href=\"http://pediatrics.aappublications.org\" target=\"_blank\">Pediatrics\u003c/a>, shows that siblings –- as young as four and a half and as old as nine –- transmitted the disease in over 35 percent of cases with mothers responsible for infecting their babies in about 20 percent of cases.\u003c/p>\n\u003cp>In the past, mothers were the most common source of infection.\u003c/p>\n\u003cp>Whooping cough causes acute spasms of coughing, which are typically followed by high-pitched “\u003ca href=\"https://www.soundsofpertussis.com/\">whoops\u003c/a>” in the struggle to breathe. Infants, especially those too young to be vaccinated, face the greatest risk of severe illness and death from pertussis, as the deadly parasite overwhelms their still developing lungs. About half of infected babies must be hospitalized.\u003c/p>\n\u003cp>For years, health officials have recommended that all pregnant women get a Tdap shot, says Tami Skoff, an epidemiologist with the Centers for Disease Control and Prevention and lead author of the study.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>“By vaccinating during pregnancy,” Skoff explains, “the mother passes protective antibodies to her baby that protect the baby against pertussis during the first few critical months of life, before the infant begins their own pertussis immunization.”\u003c/p>\n\u003cp>\u003ca href=\"http://www.nhs.uk/conditions/pregnancy-and-baby/pages/whooping-cough-vaccination-pregnant.aspx\" target=\"_blank\">Early studies\u003c/a> in the United Kingdom show that vaccinating during pregnancy is a highly effective strategy to protect infants, says Skoff.\u003c/p>\n\u003cp>After the UK program was introduced in 2012, babies whose mothers were vaccinated against pertussis at least a week before birth had a \u003ca href=\"http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60686-3/abstract\">91 percent lower risk \u003c/a>of contracting the disease than babies whose mothers did not get a shot.\u003c/p>\n\u003cp>With the shift in disease transmission from mothers to siblings, should recommendations for a booster be shifted younger than the current age of 11, if mom is expecting a baby?\u003c/p>\n\u003cp>That’s not a trivial decision, says Art Reingold, a UC Berkeley professor of public health. “Given what we know about the fairly rapid decline in vaccine-induced protection, one would want to at least model the likely effects of shifting the age for a booster.”\u003c/p>\n\u003cp>What’s more, because protection from the vaccine starts to fade from about 98 percent effectiveness to about 70 percent five years later, changing the timing of the booster could simply shift the burden of disease to other age groups, says Skoff.\u003c/p>\n\u003cp>The most effective strategy is to get all pregnant women vaccinated \u003ca href=\"http://www.cdph.ca.gov/healthinfo/discond/pages/pertussis.aspx\" target=\"_blank\">during the third trimester\u003c/a> to protect babies for the first months of life, when pertussis is most likely to cause severe, life-threatening illness, says Reingold. The next most important thing to do, he says, is to make sure young children get all their shots.\u003c/p>\n\u003cp>With an unknown source of infection for about 50 percent of cases, it’s still important for anyone who spends time with infants to be up to date on their pertussis vaccinations. Not just children, but all adults, too, including grandparents and caregivers.\u003c/p>\n\u003cp>This “\u003ca href=\"http://www.medscape.com/viewarticle/780027_2\" target=\"_blank\">cocooning\u003c/a>” strategy has been recommended since the Tdap booster was introduced in 2005. But it’s proven difficult to implement, says Reingold, in part because many adults are not inclined to get vaccinated. But even if they were, it might not matter.\u003c/p>\n\u003cp>The current “acellular” vaccine, which contains fragments of the parasite, was introduced in the late 1990s to replace the whole cell version. The whole cell vaccine afforded longer lasting protection but also caused more side effects.\u003c/p>\n\u003cp>In pertussis, the disease is caused by toxins that are released by bacteria. The pertussis vaccine protects you against those toxins, but may not prevent you from spreading the bacteria to others — and causing illness in them.\u003c/p>\n\u003cp>Already this year, California has seen \u003ca href=\"http://www.cdph.ca.gov/programs/immunize/Documents/Pertussis%2520report%25208-3-2015.pdf\" target=\"_blank\">more pertussis cases\u003c/a>, excluding the two recent epidemics, than in any year since the 1950s.\u003c/p>\n\u003cp>Public health experts would love to develop a new vaccine that is not only safe but also affords protection over the long haul. But the incentives for manufacturers to invest substantial sums in the needed research and trials are extremely limited, says Reingold. “I don’t expect a new vaccine to provide us an alternative solution in the foreseeable future.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Until then, he says, nothing offers better protection to an unvaccinated baby than being born to a recently-vaccinated mother.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>West Nile virus hit California harder than ever last year, with a record 561 cases of neuroinvasive disease -- the most serious types of the illness -- reported from the mosquito-borne virus, according to \u003ca href=\"http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6434a1.htm?s_cid=mm6434a1_e\" target=\"_blank\">federal health data\u003c/a> released Thursday.\u003c/p>\n\u003cp>The number of these serious \u003ca href=\"http://www.cdc.gov/westnile/resources/pdfs/data/3-west-nile-virus-cases-reported-to-cdc-by-state_1999-2014_06082015.pdf\" target=\"_blank\">California cases\u003c/a> was 83 percent higher than the previous record number reported in the state in 2005, according to the U.S. Centers for Disease Control and Prevention.\u003c/p>\n\u003cp>Most of those cases — 70 percent — were reported from Los Angeles and Orange counties, which recorded 15 West Nile deaths last year. Statewide, \u003ca href=\"http://www.cdc.gov/westnile/resources/pdfs/data/wnv-disease-cases-and-pvds-by-state-2014_06052015.pdf\" target=\"_blank\">31 people died\u003c/a> of West Nile disease in the state in 2014.\u003c/p>\n\u003cfigure class=\"related\">\u003cfigcaption>\u003c/figcaption>\u003c/figure>\n\u003cp>[contextly_sidebar id=\"Py7dpEJu9iLPmYbglCz7y5U5zVy0PH9U\"]The West Nile virus is spread by the bite of an infected mosquito. Mosquitoes can become infected when they feed on birds carrying the virus. Most people infected will have no symptoms, but about one in five will develop a fever with other symptoms. Even fewer people will develop the serious neuroinvasive disease tracked by the CDC, including West Nile-caused meningitis and encephalitis, but most of them will require hospitalization.\u003c/p>\n\u003cp>Public health experts say there’s no single explanation for why some West Nile virus seasons are more severe than others.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>California’s drought, last year’s particularly warm summer temperatures, and changes in bird and mosquito populations all played a role in making the 2014 West Nile virus season one of the state’s worst, said Dr. Rachel Civen, medical epidemiologist in charge of vector-borne diseases for the Los Angeles County Public Health Department. The drought reduces water available for birds and mosquitoes, which then crowd together among remaining water sources, spreading the virus.\u003c/p>\n\u003cp>Civen noted that while the new CDC data focus on neuroinvasive cases, local public health agencies, including hers, report all West Nile virus infections, including people without symptoms whose infection is detected when they donate blood.\u003c/p>\n\u003cp>In that respect, “we’re actually seeing a lot fewer cases” this year, Civen said. This week, Los Angeles County will report 10 infections, six of which were detected in asymptomatic blood donors. Last year in the same week, 49 infections were reported.\u003c/p>\n\u003cp>Statewide, \u003ca href=\"http://www.westnile.ca.gov/\" target=\"_blank\">83 human cases\u003c/a> of West Nile virus have been reported this year, according to the California Department of Public Health. Two people, from San Bernardino and Nevada counties, \u003ca href=\"http://www.cdc.gov/westnile/statsmaps/preliminarymapsdata/histatedate.html\" target=\"_blank\">have died\u003c/a> from the disease.\u003c/p>\n\u003cp>[contextly_sidebar id=\"7ZNnOH0LWnNIg6kjnLrZYtYgegGmsUKP\"]In Orange County, which had California’s highest number of infections in 2014, environmental health officials next week will start a large-scale aerial spraying campaign to control mosquitos. This will be the first aerial spraying campaign for the county, which in the past instead has “fogged” smaller areas with insecticide. The spraying campaign on Sept. 9 and 10 will cover the cities of Orange, Tustin and Villa Park, and parts of Anaheim, Fountain Valley, Garden Grove, Santa Ana and Stanton.\u003c/p>\n\u003cp>As of last week, five people in Orange County had been infected with West Nile virus, according to the county’s public health department.\u003c/p>\n\u003cp>West Nile virus emerged in the United States in 1999 and was first reported in California in 2002. By 2004, the virus was reported in all of the state’s 58 counties.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story was produced by \u003c/em>\u003ca href=\"http://khn.org\">\u003cem>Kaiser Health News\u003c/em>\u003c/a>\u003cem>, a nonprofit news organization covering health care policy and politics. It is an editorially independent program of the \u003c/em>\u003ca href=\"http://www.kff.org/\">\u003cstrong>\u003cem>Kaiser Family Foundation\u003c/em>\u003c/strong>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>West Nile virus hit California harder than ever last year, with a record 561 cases of neuroinvasive disease -- the most serious types of the illness -- reported from the mosquito-borne virus, according to \u003ca href=\"http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6434a1.htm?s_cid=mm6434a1_e\" target=\"_blank\">federal health data\u003c/a> released Thursday.\u003c/p>\n\u003cp>The number of these serious \u003ca href=\"http://www.cdc.gov/westnile/resources/pdfs/data/3-west-nile-virus-cases-reported-to-cdc-by-state_1999-2014_06082015.pdf\" target=\"_blank\">California cases\u003c/a> was 83 percent higher than the previous record number reported in the state in 2005, according to the U.S. Centers for Disease Control and Prevention.\u003c/p>\n\u003cp>Most of those cases — 70 percent — were reported from Los Angeles and Orange counties, which recorded 15 West Nile deaths last year. Statewide, \u003ca href=\"http://www.cdc.gov/westnile/resources/pdfs/data/wnv-disease-cases-and-pvds-by-state-2014_06052015.pdf\" target=\"_blank\">31 people died\u003c/a> of West Nile disease in the state in 2014.\u003c/p>\n\u003cfigure class=\"related\">\u003cfigcaption>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>The West Nile virus is spread by the bite of an infected mosquito. Mosquitoes can become infected when they feed on birds carrying the virus. Most people infected will have no symptoms, but about one in five will develop a fever with other symptoms. Even fewer people will develop the serious neuroinvasive disease tracked by the CDC, including West Nile-caused meningitis and encephalitis, but most of them will require hospitalization.\u003c/p>\n\u003cp>Public health experts say there’s no single explanation for why some West Nile virus seasons are more severe than others.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>California’s drought, last year’s particularly warm summer temperatures, and changes in bird and mosquito populations all played a role in making the 2014 West Nile virus season one of the state’s worst, said Dr. Rachel Civen, medical epidemiologist in charge of vector-borne diseases for the Los Angeles County Public Health Department. The drought reduces water available for birds and mosquitoes, which then crowd together among remaining water sources, spreading the virus.\u003c/p>\n\u003cp>Civen noted that while the new CDC data focus on neuroinvasive cases, local public health agencies, including hers, report all West Nile virus infections, including people without symptoms whose infection is detected when they donate blood.\u003c/p>\n\u003cp>In that respect, “we’re actually seeing a lot fewer cases” this year, Civen said. This week, Los Angeles County will report 10 infections, six of which were detected in asymptomatic blood donors. Last year in the same week, 49 infections were reported.\u003c/p>\n\u003cp>Statewide, \u003ca href=\"http://www.westnile.ca.gov/\" target=\"_blank\">83 human cases\u003c/a> of West Nile virus have been reported this year, according to the California Department of Public Health. Two people, from San Bernardino and Nevada counties, \u003ca href=\"http://www.cdc.gov/westnile/statsmaps/preliminarymapsdata/histatedate.html\" target=\"_blank\">have died\u003c/a> from the disease.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>In Orange County, which had California’s highest number of infections in 2014, environmental health officials next week will start a large-scale aerial spraying campaign to control mosquitos. This will be the first aerial spraying campaign for the county, which in the past instead has “fogged” smaller areas with insecticide. The spraying campaign on Sept. 9 and 10 will cover the cities of Orange, Tustin and Villa Park, and parts of Anaheim, Fountain Valley, Garden Grove, Santa Ana and Stanton.\u003c/p>\n\u003cp>As of last week, five people in Orange County had been infected with West Nile virus, according to the county’s public health department.\u003c/p>\n\u003cp>West Nile virus emerged in the United States in 1999 and was first reported in California in 2002. By 2004, the virus was reported in all of the state’s 58 counties.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story was produced by \u003c/em>\u003ca href=\"http://khn.org\">\u003cem>Kaiser Health News\u003c/em>\u003c/a>\u003cem>, a nonprofit news organization covering health care policy and politics. It is an editorially independent program of the \u003c/em>\u003ca href=\"http://www.kff.org/\">\u003cstrong>\u003cem>Kaiser Family Foundation\u003c/em>\u003c/strong>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "No New Infections in Hundreds Taking Pill to Prevent HIV",
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"content": "\u003cp>Among hundreds of HIV-negative people using pre-exposure prophylaxis, known as PrEP, there were no new HIV infections over a two-and-a-half-year period, according to \u003ca href=\"http://cid.oxfordjournals.org/content/early/2015/09/01/cid.civ778.abstract\" target=\"_blank\">an analysis \u003c/a>by researchers at Kaiser San Francisco published Wednesday.\u003c/p>\n\u003cp>In the study, researchers at Kaiser San Francisco followed 657 of its patients who were referred for PrEP and then followed the regimen. In an interview, lead author Dr. Jonathan Volk, an infectious disease specialist with Kaiser called the results \"incredibly exciting.\"\u003c/p>\n\u003cp>\"I was optimistic, but this is even more ... reassuring than I had expected initially,\" he said. \"It really reinforces how well this medication can work to help reduce risk for HIV for patients who are using it daily.\"\u003c/p>\n\u003cp>In the study, published in Clinical Infectious Diseases, almost all the participants -- 99 percent -- were men who have sex with men.\u003c/p>\n\u003cp>In 2012, the FDA \u003ca href=\"http://ww2.kqed.org/news/2012/07/16/fda-approves-truvada-as-first-medication-to-reduce-hiv-risk-in-healthy-people\" target=\"_blank\">approved the drug Truvada\u003c/a> to help people who are HIV-negative to avoid becoming infected. While studies showed it to be highly effective, some advocates were concerned that use of the drug would lead to unsafe behavior -- and HIV infection.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[contextly_sidebar id=\"Z3PBxmIAbFpdzMPl82A4D1i3wxvUuOkG\"]Yet in 2014, the U.S. Public Health Service published guidelines for PrEP and in July, President Obama \u003ca href=\"https://www.whitehouse.gov/the-press-office/2015/07/30/fact-sheet-national-hivaids-strategy-updated-2020\" target=\"_blank\">signed an executive order\u003c/a> updating the National HIV/AIDS Strategy to include full access to PrEP for those who want it.\u003c/p>\n\u003cp>Volk said the Kaiser study is significant in part because of the success during real-world application. Researchers tracked condom use and sexually transmitted infections and found that 41 percent of participants reported a decrease in their use of condoms, and half were diagnosed with a sexually transmitted disease in the first year after starting PrEP.\u003c/p>\n\u003cp>\"The fact that we've seen as many sexually transmitted infections as we have and not seen any new HIV infections really reinforces that this medication seems to work very well, even in a high-risk setting,\" Volk said.\u003c/p>\n\u003cp>\u003cstrong>\"Remarkable Study\"\u003c/strong>\u003c/p>\n\u003cp>Dr. Susan Buchbinder is director of the HIV Research Section for the San Francisco Department of Public Health and was not involved with the analysis.\u003c/p>\n\u003cp>\"It's a remarkable study,\" she said. \"It's critically important. This really demonstrates that in a ... very busy clinical setting, the systems can be developed to adequately and accurately screen people for PrEP, put them on PrEP, and follow them over time.\"\u003c/p>\n\u003cp>Paul Marcelin started PrEP in July, 2013 as part of a separate one-year study. When that wrapped up, Marcelin, 40, who lives in Alameda but is a Kaiser San Francisco patient, continued on PrEP with Kaiser.\u003c/p>\n\u003cp>\"It's been wonderful to receive this care from my regular provider,\" he said in an interview.\u003c/p>\n\u003cp>Marcelin's boyfriend of one year is HIV positive. Fifteen years ago, Marcelin said he dated another man who was HIV positive. \"It was a barrier in our sex life and in our intimacy,\" he said. \"It's amazing to think that today I've met a new person, an amazing person, and we don't have any fear. We have a completely natural sex life.\"\u003c/p>\n\u003cp>Marcelin says he's experienced no side effects from taking Truvada. It is recommended that anyone on Truvada is tested for HIV and other sexually transmitted infections every three months. Patients are also monitored for drug side effects, especially changes in kidney function.\u003c/p>\n\u003cp>\u003cstrong>Stigma Remains\u003c/strong>\u003c/p>\n\u003cp>Despite the success of PrEP as a preventive, stigma remains. People who take PrEP are sometimes viewed as promiscuous, Marcelin told me. \"People say, 'Why are you not just using condoms?' ... Sometimes people say, 'You must be slut.' So there's negative stigma.\"\u003c/p>\n\u003cp>Another barrier may be cost -- $15,000 annually or $1,250 per month. Insurance does cover at least some of the cost, but how much is dependent on the type of insurance an individual has. Gilead, which makes Truvada, will reimburse patients up to $300 per month. Marcelin's cost sharing after his Kaiser plan is $35 per month, and he says Gilead reimburses that.\u003c/p>\n\u003cp>[contextly_sidebar id=\"TYpef1eMvxU4HPsSLQDHrpynDtuBeiCQ\"]Buchbinder helps direct an ambitious campaign to eliminate new HIV infections in San Francisco called \u003ca href=\"http://www.gettingtozerosf.org\" target=\"_blank\">Getting to Zero\u003c/a>. For years, new infections have been declining. Between 2006 and 2014, new infections in men who have sex with men fell from 357 to 221, nearly a 40 percent decline. The decline in new infections by race/ethnicity are also significant. Again, new HIV infections declined as follows, from 2006 to 2014:\u003c/p>\n\u003cul>\n\u003cli>Whites: 278 to 136\u003c/li>\n\u003cli>African American: 75 to 33\u003c/li>\n\u003cli>Latino: 113 to 82\u003c/li>\n\u003c/ul>\n\u003cp>PrEP is a strong component of the campaign, but it's \"really the culmination of many, many different things that the city has been doing in particular over the last five years,\" Buchbinder said. \u003cstrong>\u003cem> \u003c/em>\u003c/strong>\u003c/p>\n\u003cp>Kaiser is continuing to monitor its patients on PrEP. Demand for PrEP is growing. Volk said that at the time the analysis was submitted, there were the 600-plus patients, today it's closer to 900.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"What is exciting for me as a clinician,\" Volk said \"is now I have many different tools I can use to help prevent HIV, and PrEP is one of them. PrEP is probably not right for all my patients ... but it is for many of them.\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Among hundreds of HIV-negative people using pre-exposure prophylaxis, known as PrEP, there were no new HIV infections over a two-and-a-half-year period, according to \u003ca href=\"http://cid.oxfordjournals.org/content/early/2015/09/01/cid.civ778.abstract\" target=\"_blank\">an analysis \u003c/a>by researchers at Kaiser San Francisco published Wednesday.\u003c/p>\n\u003cp>In the study, researchers at Kaiser San Francisco followed 657 of its patients who were referred for PrEP and then followed the regimen. In an interview, lead author Dr. Jonathan Volk, an infectious disease specialist with Kaiser called the results \"incredibly exciting.\"\u003c/p>\n\u003cp>\"I was optimistic, but this is even more ... reassuring than I had expected initially,\" he said. \"It really reinforces how well this medication can work to help reduce risk for HIV for patients who are using it daily.\"\u003c/p>\n\u003cp>In the study, published in Clinical Infectious Diseases, almost all the participants -- 99 percent -- were men who have sex with men.\u003c/p>\n\u003cp>In 2012, the FDA \u003ca href=\"http://ww2.kqed.org/news/2012/07/16/fda-approves-truvada-as-first-medication-to-reduce-hiv-risk-in-healthy-people\" target=\"_blank\">approved the drug Truvada\u003c/a> to help people who are HIV-negative to avoid becoming infected. While studies showed it to be highly effective, some advocates were concerned that use of the drug would lead to unsafe behavior -- and HIV infection.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>Yet in 2014, the U.S. Public Health Service published guidelines for PrEP and in July, President Obama \u003ca href=\"https://www.whitehouse.gov/the-press-office/2015/07/30/fact-sheet-national-hivaids-strategy-updated-2020\" target=\"_blank\">signed an executive order\u003c/a> updating the National HIV/AIDS Strategy to include full access to PrEP for those who want it.\u003c/p>\n\u003cp>Volk said the Kaiser study is significant in part because of the success during real-world application. Researchers tracked condom use and sexually transmitted infections and found that 41 percent of participants reported a decrease in their use of condoms, and half were diagnosed with a sexually transmitted disease in the first year after starting PrEP.\u003c/p>\n\u003cp>\"The fact that we've seen as many sexually transmitted infections as we have and not seen any new HIV infections really reinforces that this medication seems to work very well, even in a high-risk setting,\" Volk said.\u003c/p>\n\u003cp>\u003cstrong>\"Remarkable Study\"\u003c/strong>\u003c/p>\n\u003cp>Dr. Susan Buchbinder is director of the HIV Research Section for the San Francisco Department of Public Health and was not involved with the analysis.\u003c/p>\n\u003cp>\"It's a remarkable study,\" she said. \"It's critically important. This really demonstrates that in a ... very busy clinical setting, the systems can be developed to adequately and accurately screen people for PrEP, put them on PrEP, and follow them over time.\"\u003c/p>\n\u003cp>Paul Marcelin started PrEP in July, 2013 as part of a separate one-year study. When that wrapped up, Marcelin, 40, who lives in Alameda but is a Kaiser San Francisco patient, continued on PrEP with Kaiser.\u003c/p>\n\u003cp>\"It's been wonderful to receive this care from my regular provider,\" he said in an interview.\u003c/p>\n\u003cp>Marcelin's boyfriend of one year is HIV positive. Fifteen years ago, Marcelin said he dated another man who was HIV positive. \"It was a barrier in our sex life and in our intimacy,\" he said. \"It's amazing to think that today I've met a new person, an amazing person, and we don't have any fear. We have a completely natural sex life.\"\u003c/p>\n\u003cp>Marcelin says he's experienced no side effects from taking Truvada. It is recommended that anyone on Truvada is tested for HIV and other sexually transmitted infections every three months. Patients are also monitored for drug side effects, especially changes in kidney function.\u003c/p>\n\u003cp>\u003cstrong>Stigma Remains\u003c/strong>\u003c/p>\n\u003cp>Despite the success of PrEP as a preventive, stigma remains. People who take PrEP are sometimes viewed as promiscuous, Marcelin told me. \"People say, 'Why are you not just using condoms?' ... Sometimes people say, 'You must be slut.' So there's negative stigma.\"\u003c/p>\n\u003cp>Another barrier may be cost -- $15,000 annually or $1,250 per month. Insurance does cover at least some of the cost, but how much is dependent on the type of insurance an individual has. Gilead, which makes Truvada, will reimburse patients up to $300 per month. Marcelin's cost sharing after his Kaiser plan is $35 per month, and he says Gilead reimburses that.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>Buchbinder helps direct an ambitious campaign to eliminate new HIV infections in San Francisco called \u003ca href=\"http://www.gettingtozerosf.org\" target=\"_blank\">Getting to Zero\u003c/a>. For years, new infections have been declining. Between 2006 and 2014, new infections in men who have sex with men fell from 357 to 221, nearly a 40 percent decline. The decline in new infections by race/ethnicity are also significant. Again, new HIV infections declined as follows, from 2006 to 2014:\u003c/p>\n\u003cul>\n\u003cli>Whites: 278 to 136\u003c/li>\n\u003cli>African American: 75 to 33\u003c/li>\n\u003cli>Latino: 113 to 82\u003c/li>\n\u003c/ul>\n\u003cp>PrEP is a strong component of the campaign, but it's \"really the culmination of many, many different things that the city has been doing in particular over the last five years,\" Buchbinder said. \u003cstrong>\u003cem> \u003c/em>\u003c/strong>\u003c/p>\n\u003cp>Kaiser is continuing to monitor its patients on PrEP. Demand for PrEP is growing. Volk said that at the time the analysis was submitted, there were the 600-plus patients, today it's closer to 900.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"What is exciting for me as a clinician,\" Volk said \"is now I have many different tools I can use to help prevent HIV, and PrEP is one of them. PrEP is probably not right for all my patients ... but it is for many of them.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Freezing Eggs May Reduce A Woman's Odds Of Success With IVF",
"title": "Freezing Eggs May Reduce A Woman's Odds Of Success With IVF",
"headTitle": "State of Health | KQED News",
"content": "\u003cp>With egg freezing being touted as a way for women to potentially expand future childbearing options, the viability of those eggs when they're defrosted is still relatively unknown. The latest bit of guardedly good news is a short report in \u003cem>JAMA\u003c/em> indicating that frozen eggs do indeed lead to live births after IVF nearly half the time — but that the odds of a live birth are almost 20 percent higher for IVF using fresh eggs.\u003c/p>\n\u003cp>The \u003ca href=\"http://jama.jamanetwork.com/article.aspx?articleid=2425734&resultClick=3\" target=\"_blank\">report\u003c/a>, by Vitaly Kushnir and his colleagues at the Center for Human Reproduction in New York, is based on a retrospective analysis of success rates that U.S. fertility clinics send to the \u003ca href=\"http://www.sart.org/\">Society for Assisted Reproductive Technology\u003c/a>. In 2013, donated eggs (as opposed to eggs from the would-be mother herself) were used in 11,148 IVF cycles. Most were fertilized and implanted as soon as they were retrieved, while 20 percent had been frozen after donation and were then thawed and fertilized. Kushnir and his colleagues looked at IVF success rates in terms of eventual live births and compared the rates for those using fresh donor eggs with those using frozen donor eggs.\u003c/p>\n\u003cp>The live birthrates per embryo transferred were 56.1 percent for embryos made with fresh donor eggs and 47.1 percent for those made with frozen donor eggs. In other words, a live birth was 19.1 percent more likely using fresh donor eggs rather than frozen.\u003c/p>\n\u003cp>It's hard to say what might account for this difference, Kushnir said. \"The quality of the eggs could be somehow diminished by freezing and thawing.\" Or it could be explained by the fact that women who use frozen donor eggs get fewer eggs altogether, since they're split among a couple of recipients — and fewer eggs means fewer potential embryos.\u003c/p>\n\u003cp>In most clinics, a woman who uses a donor gets all the fresh eggs the donor produces — which, according to Dr. James Toner, president of SART, is usually about 15 to 20 mature eggs. But if she has to turn to frozen eggs from the egg bank, which he said are typically sold in batches of about half a dozen, she will usually have to share that batch with another woman.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Since fertility clinics these days implant just one or two embryos per cycle, \"I think the difference in initial egg numbers in fresh versus frozen largely explains the difference in pregnancy rate,\" said Toner, who works at the Center for Reproductive Medicine in Atlanta.\u003c/p>\n\u003cp>So if you're using donor eggs, why opt for frozen instead of fresh? Two reasons, according to SART and the American Society of Reproductive Medicine, which issued a \u003ca href=\"http://www.reproductivefacts.org/ASRM_and_SART_released_the_following_comments_on_Outcomes_of_Fresh_and_Cryopreserved_Oocyte_Donation/\">joint statement\u003c/a> in response to the \u003cem>JAMA\u003c/em> report. The first is cost: A cycle of IVF using donor eggs costs roughly half as much if the eggs are frozen — generally about $15,000 to $17,000 for frozen donor eggs, compared with $25,000 to $30,000 for fresh.\u003c/p>\n\u003cp>The second is convenience. As the SART/ASRM statement points out, using frozen donor eggs gives women \"access to a wider field of donors and provides greater flexibility for both donors' and recipients' scheduling and coordination.\" These considerations, the group said, \"may outweigh slightly lower success rates for some patients.\"\u003c/p>\n\u003cp>Unfortunately, it's hard to draw too many conclusions from this study about egg freezing as it's most commonly used these days: on eggs that are about a decade older than typical donor eggs, frozen by women in their late 30s who want to extend their fertility by a few more years.\u003c/p>\n\u003cp>Donor eggs generally come from young women; most fertility clinics look for egg donors in their 20s. Younger donors are preferred because their eggs are more likely to become fertilized in the first place, and once they're fertilized the resulting embryos are more likely to be successfully implanted in a recipient's uterus.\u003c/p>\n\u003cp>Currently, though, the typical cryopreserver is much older — a single woman in her late 30s (one \u003ca href=\"http://www.fertstert.org/article/S0015-0282%2811%2901693-1/pdf\" target=\"_blank\">study\u003c/a> put the average age of elective egg freezing at 37.4). Does the \u003cem>JAMA\u003c/em> report say anything about how likely it is for that woman to have a child once she decides she's ready — which might not be until her 40s?\u003c/p>\n\u003cp>\"That's the same question every other journalist asks,\" Kushnir told me.\u003c/p>\n\u003cp>And what do you tell them?\u003c/p>\n\u003cp>\"Well, we can extrapolate from the data,\" he said, \"but there's no direct evidence in this study\" of how older eggs will fare when they are frozen and then thawed. All he can really say is that the odds of success are lower for frozen eggs than they are for fresh, which is probably as true for older eggs as it is for younger.\u003c/p>\n\u003cp>Older women can improve their chances of getting pregnant post-freezing, Kushnir added, by freezing an embryo instead of an egg, since embryos allow for a greater margin of error when they're defrosted.\u003c/p>\n\u003cp>\"They're approximately the same size,\" he said, \"but an egg is just one big huge cell. If you thaw it and it doesn't thaw well, you lose the whole cell.\" But an embryo is a group of cells, usually eight. \"When you thaw the embryo, if some of those cells die — say, if only six of the eight survive the thaw — those cells are pluripotent and can continue to divide and grow and still produce a pregnancy.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>But while freezing embryos might be a better option biologically, socially it's pretty much a nonstarter. A 37-year-old woman considering egg freezing generally doesn't have a partner whose sperm she wants to use to create an embryo; if she did, she might be choosing to get pregnant instead. And once you start thinking about using donor sperm to make an embryo to put in the deep freeze, thinking about using a donor egg when you're finally ready to have a baby might not be that far a leap.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Freezing+Eggs+May+Reduce+A+Woman%27s+Odds+Of+Success+With+IVF&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n",
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"excerpt": "Women who used frozen donor eggs instead of fresh for IVF had lower odds of having a baby, a study finds. But doctors say frozen eggs remain a good option for many women.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>With egg freezing being touted as a way for women to potentially expand future childbearing options, the viability of those eggs when they're defrosted is still relatively unknown. The latest bit of guardedly good news is a short report in \u003cem>JAMA\u003c/em> indicating that frozen eggs do indeed lead to live births after IVF nearly half the time — but that the odds of a live birth are almost 20 percent higher for IVF using fresh eggs.\u003c/p>\n\u003cp>The \u003ca href=\"http://jama.jamanetwork.com/article.aspx?articleid=2425734&resultClick=3\" target=\"_blank\">report\u003c/a>, by Vitaly Kushnir and his colleagues at the Center for Human Reproduction in New York, is based on a retrospective analysis of success rates that U.S. fertility clinics send to the \u003ca href=\"http://www.sart.org/\">Society for Assisted Reproductive Technology\u003c/a>. In 2013, donated eggs (as opposed to eggs from the would-be mother herself) were used in 11,148 IVF cycles. Most were fertilized and implanted as soon as they were retrieved, while 20 percent had been frozen after donation and were then thawed and fertilized. Kushnir and his colleagues looked at IVF success rates in terms of eventual live births and compared the rates for those using fresh donor eggs with those using frozen donor eggs.\u003c/p>\n\u003cp>The live birthrates per embryo transferred were 56.1 percent for embryos made with fresh donor eggs and 47.1 percent for those made with frozen donor eggs. In other words, a live birth was 19.1 percent more likely using fresh donor eggs rather than frozen.\u003c/p>\n\u003cp>It's hard to say what might account for this difference, Kushnir said. \"The quality of the eggs could be somehow diminished by freezing and thawing.\" Or it could be explained by the fact that women who use frozen donor eggs get fewer eggs altogether, since they're split among a couple of recipients — and fewer eggs means fewer potential embryos.\u003c/p>\n\u003cp>In most clinics, a woman who uses a donor gets all the fresh eggs the donor produces — which, according to Dr. James Toner, president of SART, is usually about 15 to 20 mature eggs. But if she has to turn to frozen eggs from the egg bank, which he said are typically sold in batches of about half a dozen, she will usually have to share that batch with another woman.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Since fertility clinics these days implant just one or two embryos per cycle, \"I think the difference in initial egg numbers in fresh versus frozen largely explains the difference in pregnancy rate,\" said Toner, who works at the Center for Reproductive Medicine in Atlanta.\u003c/p>\n\u003cp>So if you're using donor eggs, why opt for frozen instead of fresh? Two reasons, according to SART and the American Society of Reproductive Medicine, which issued a \u003ca href=\"http://www.reproductivefacts.org/ASRM_and_SART_released_the_following_comments_on_Outcomes_of_Fresh_and_Cryopreserved_Oocyte_Donation/\">joint statement\u003c/a> in response to the \u003cem>JAMA\u003c/em> report. The first is cost: A cycle of IVF using donor eggs costs roughly half as much if the eggs are frozen — generally about $15,000 to $17,000 for frozen donor eggs, compared with $25,000 to $30,000 for fresh.\u003c/p>\n\u003cp>The second is convenience. As the SART/ASRM statement points out, using frozen donor eggs gives women \"access to a wider field of donors and provides greater flexibility for both donors' and recipients' scheduling and coordination.\" These considerations, the group said, \"may outweigh slightly lower success rates for some patients.\"\u003c/p>\n\u003cp>Unfortunately, it's hard to draw too many conclusions from this study about egg freezing as it's most commonly used these days: on eggs that are about a decade older than typical donor eggs, frozen by women in their late 30s who want to extend their fertility by a few more years.\u003c/p>\n\u003cp>Donor eggs generally come from young women; most fertility clinics look for egg donors in their 20s. Younger donors are preferred because their eggs are more likely to become fertilized in the first place, and once they're fertilized the resulting embryos are more likely to be successfully implanted in a recipient's uterus.\u003c/p>\n\u003cp>Currently, though, the typical cryopreserver is much older — a single woman in her late 30s (one \u003ca href=\"http://www.fertstert.org/article/S0015-0282%2811%2901693-1/pdf\" target=\"_blank\">study\u003c/a> put the average age of elective egg freezing at 37.4). Does the \u003cem>JAMA\u003c/em> report say anything about how likely it is for that woman to have a child once she decides she's ready — which might not be until her 40s?\u003c/p>\n\u003cp>\"That's the same question every other journalist asks,\" Kushnir told me.\u003c/p>\n\u003cp>And what do you tell them?\u003c/p>\n\u003cp>\"Well, we can extrapolate from the data,\" he said, \"but there's no direct evidence in this study\" of how older eggs will fare when they are frozen and then thawed. All he can really say is that the odds of success are lower for frozen eggs than they are for fresh, which is probably as true for older eggs as it is for younger.\u003c/p>\n\u003cp>Older women can improve their chances of getting pregnant post-freezing, Kushnir added, by freezing an embryo instead of an egg, since embryos allow for a greater margin of error when they're defrosted.\u003c/p>\n\u003cp>\"They're approximately the same size,\" he said, \"but an egg is just one big huge cell. If you thaw it and it doesn't thaw well, you lose the whole cell.\" But an embryo is a group of cells, usually eight. \"When you thaw the embryo, if some of those cells die — say, if only six of the eight survive the thaw — those cells are pluripotent and can continue to divide and grow and still produce a pregnancy.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>But while freezing embryos might be a better option biologically, socially it's pretty much a nonstarter. A 37-year-old woman considering egg freezing generally doesn't have a partner whose sperm she wants to use to create an embryo; if she did, she might be choosing to get pregnant instead. And once you start thinking about using donor sperm to make an embryo to put in the deep freeze, thinking about using a donor egg when you're finally ready to have a baby might not be that far a leap.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Freezing+Eggs+May+Reduce+A+Woman%27s+Odds+Of+Success+With+IVF&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Snooze Alert: A Sleep Disorder May Be Harming Your Body And Brain",
"title": "Snooze Alert: A Sleep Disorder May Be Harming Your Body And Brain",
"headTitle": "State of Health | KQED News",
"content": "\u003cp>It's time for consumers to wake up to the risks of sleep disorders, scientists say.\u003c/p>\n\u003cp>More than 50 million adults in the U.S. have a disorder such as insomnia, restless leg syndrome or sleep apnea, according to an Institute of Medicine \u003ca href=\"http://iom.nationalacademies.org/Reports/2006/Sleep-Disorders-and-Sleep-Deprivation-An-Unmet-Public-Health-Problem.aspx\" target=\"_blank\">report\u003c/a>. And it's now clear that a lack of sleep \"not only increases the risk of errors and accidents, it also has adverse effects on the body and brain,\" according to Charles Czeisler, chief of the division of sleep and circadian disorders at Brigham and Women's Hospital in Boston.\u003c/p>\n\u003cp>\u003ca href=\"http://www.cdc.gov/features/dssleep/\" target=\"_blank\">Research\u003c/a> in the past couple of decades has shown that a lack of sleep increases a person's risk for cardiovascular disease, diabetes, infections and maybe even Alzheimer's disease. Yet most sleep disorders go untreated.\u003c/p>\n\u003cp>Michael Arnott, who is now 67, began having sleep problems in his 50s, he says. As a result, he often found himself having trouble staying awake during long drives on the Massachusetts Turnpike.\u003c/p>\n\u003cp>\"I would get groggy and feel like I've got to keep talking, open the window,\" Arnott says.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>His wife, Mary White, says being a passenger on those drives could be scary.\u003c/p>\n\u003cp>\"All of a sudden there'd be a change in the speed and I'd look over, and his eyes would be starting to close,\" she remembers.\u003c/p>\n\u003cp>White thought her husband might have sleep \u003ca href=\"http://www.nhlbi.nih.gov/health/health-topics/topics/sleepapnea\" target=\"_blank\">apnea\u003c/a>, which interferes with breathing. But Arnott was in denial. He figured he was free of most risk factors for apnea. He wasn't overweight, he didn't smoke or take sedatives, and he has always stayed in great shape.\u003c/p>\n\u003cp>\"I'm a runner. I've run for more than 40 years,\" he says. \"I used to do marathons. Now I just do 5- and 10-kilometer road races.\"\u003c/p>\n\u003cp>So his wife took the initiative. \"I asked him to see a doctor and he wouldn't,\" she says. In 2012, though, White persuaded him to take part in a sleep research study that paid for his participation, and took place at a sleep lab in Boston, not too far from the couple's home in Cambridge.\u003c/p>\n\u003cp>Doctors found a couple of problems. \"I've got what they call moderate obstructive sleep apnea,\" Arnott says. He also has a form of \u003ca href=\"http://www.ninds.nih.gov/disorders/restless_legs/detail_restless_legs.htm\" target=\"_blank\">restless leg syndrome\u003c/a> that causes him to kick during sleep.\u003c/p>\n\u003cp>Those conditions, along with his tendency to stay up late and wake up early, meant he wasn't getting enough quality sleep. And research in the past couple of decades has shown that's a problem even if you're not nodding off on the Massachusetts Turnpike.\u003c/p>\n\u003cp>Much of that research was done in the same sleep lab at Brigham and Women's Hospital where Arnott was diagnosed. The lab includes rooms that are completely isolated from the light, sounds and even vibrations of the outside world. As study participants sleep in these rooms, their brain waves, respiration, oxygen levels and other signs can be monitored from a central control room.\u003c/p>\n\u003cp>In highly controlled environments like this one, Czeisler and other researchers have shown that sleep affects everything from blood pressure to memory to metabolism.\u003c/p>\n\u003cp>\"Within 2 1/2 weeks we can take someone who is young, healthy and fit and put them in a pre-diabetic state just by putting them on an irregular schedule,\" Czeisler says.\u003c/p>\n\u003cp>Research also has shown a strong connection between sleep and the immune system, Czeisler says. \"People who are not getting sleep, if they're exposed to a virus like the adenovirus — that causes the common cold — they will have a 200 to 300 percent increased risk of actually catching a cold,\" he says.\u003c/p>\n\u003cp>Many studies suggest that a lack of sleep raises the risk of a heart attack or stroke. And most recently, Czeisler says, scientists have found \u003ca href=\"https://www.alzinfo.org/articles/poor-sleep-may-be-linked-to-alzheimers-disease/\" target=\"_blank\">evidence\u003c/a> that the brain actually needs sleep to stay healthy.\u003c/p>\n\u003cp>\"It's during sleep that we clear out many of the toxins that build up during wakefulness,\" Czeisler says. Among those toxins is beta-amyloid, which produces the sticky plaques that appear in the brains of people with Alzheimer's disease.\u003c/p>\n\u003cp>Most sleep disorders can be treated, but often they aren't. Arnott, the sleepy driver from Cambridge, didn't address his symptoms until his wife pushed him to take part in a sleep study.\u003c/p>\n\u003cfigure id=\"attachment_66824\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/cpap-machine_enl-d9fb74618f9efb012da832fa3f8d290dfbaa3fc2-e1440437424497.jpg\">\u003cimg class=\"size-thumbnail wp-image-66824\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/cpap-machine_enl-d9fb74618f9efb012da832fa3f8d290dfbaa3fc2-400x266.jpg\" alt=\"When worn at night, the mask of a CPAP (continuous positive airway pressure) machine delivers enough air pressure to keep the upper airway passages open. Blocked passages are behind the poor sleep and other symptoms associated with obstructive sleep apnea.\" width=\"400\" height=\"266\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">When worn at night, the mask of a CPAP (continuous positive airway pressure) machine delivers enough air pressure to keep the upper airway passages open. Blocked passages are behind the poor sleep and other symptoms associated with obstructive sleep apnea. \u003ccite>(Dr. P. Marazzi/Science Source)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"My whole clinic is full of patients who are brought in by their spouses,\" says Dr. Andrew Wellman, a sleep specialist at Harvard and Brigham and Women's who has cared for Arnott.\u003c/p>\n\u003cp>When Wellman is assessing a new patient, he asks a simple question: \"Do your eyelids get heavy when you'd prefer to be awake?\" If the answer is yes, that is a very specific indication that someone isn't getting enough sleep. Symptoms such as fatigue or feeling tired are less specific, and can have other causes, he says.\u003c/p>\n\u003cp>Much of Wellman's practice is devoted to sleep apnea, which affects about 1 in 3 adult men and becomes more common with age.\u003c/p>\n\u003cp>Wellman says a sleep apnea diagnosis usually requires an overnight sleep study to measure the flow of air in and out of the lungs. \"If that flow is diminished, then that is the primary measurement that we use to detect these sleep apnea events,\" he says.\u003c/p>\n\u003cp>The problem can be in the brain — a condition called central apnea. But more often the airway is getting blocked repeatedly during sleep, a disorder called obstructive sleep apnea.\u003c/p>\n\u003cp>Arnott has an unusual variant of obstructive sleep apnea, Wellman says. \"His airway actually collapses at the epiglottis, which is a structure just below the base of the tongue that prevents food from going down in the airway.\"\u003c/p>\n\u003cp>Regardless of the cause, the go-to treatment for sleep apnea is a continuous positive airway pressure (CPAP) machine. Arnott tried one for three months and hated it.\u003c/p>\n\u003cfigure id=\"attachment_66825\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/sleep-science-1_enl-501e441057efbfa64b8bcc5154019da948b34b5d-e1440437318243.jpg\">\u003cimg class=\"size-full wp-image-66825\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/sleep-science-1_enl-501e441057efbfa64b8bcc5154019da948b34b5d-e1440437318243.jpg\" alt='Instead of relying on forced air to keep his airway open when he sleeps, Arnott now wears this soft oral appliance at night. The device is more comfortable than CPAP, he says, and has decreased his apnea symptoms to \"negligible\" or \"mild.\"' width=\"1920\" height=\"1279\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Instead of relying on forced air to keep his airway open when he sleeps, Arnott now wears this soft oral appliance at night. The device is more comfortable than CPAP, he says, and has decreased his apnea symptoms to \"negligible\" or \"mild.\" \u003ccite>(M. Scott Bauer for NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"You have to have a mask on your face; you have a machine making noise all night, and you have to have electricity,\" he says. \"We hike. We go to places in the White Mountains of New Hampshire and Maine, where electricity is not always there.\"\u003c/p>\n\u003cp>Complaints like those are pretty common among people using CPAP machines, Wellman says. \"Somewhere around 50 percent of patients don't adhere to their therapy. Probably there are many people that don't even come to the sleep lab because they know they might get that breathing machine, and they don't want it.\"\u003c/p>\n\u003cp>One alternative is surgery to help keep the airway open. Another is an oral appliance that moves the lower jaw forward.\u003c/p>\n\u003cp>Arnott eventually switched to an oral appliance and has made a series of other changes. He sleeps on his side, which reduces apnea. He tries to get to bed at the same time each night. And he has begun doing yoga before bedtime, which he says helps with his restless leg syndrome.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Those steps have made a big difference, Arnott says. For one thing, he no longer falls asleep at the wheel. And now, he says, \"There are times on long trips when Mary actually says, 'I'm getting groggy. You drive.' \"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Snooze+Alert%3A+A+Sleep+Disorder+May+Be+Harming+Your+Body+And+Brain&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>It's time for consumers to wake up to the risks of sleep disorders, scientists say.\u003c/p>\n\u003cp>More than 50 million adults in the U.S. have a disorder such as insomnia, restless leg syndrome or sleep apnea, according to an Institute of Medicine \u003ca href=\"http://iom.nationalacademies.org/Reports/2006/Sleep-Disorders-and-Sleep-Deprivation-An-Unmet-Public-Health-Problem.aspx\" target=\"_blank\">report\u003c/a>. And it's now clear that a lack of sleep \"not only increases the risk of errors and accidents, it also has adverse effects on the body and brain,\" according to Charles Czeisler, chief of the division of sleep and circadian disorders at Brigham and Women's Hospital in Boston.\u003c/p>\n\u003cp>\u003ca href=\"http://www.cdc.gov/features/dssleep/\" target=\"_blank\">Research\u003c/a> in the past couple of decades has shown that a lack of sleep increases a person's risk for cardiovascular disease, diabetes, infections and maybe even Alzheimer's disease. Yet most sleep disorders go untreated.\u003c/p>\n\u003cp>Michael Arnott, who is now 67, began having sleep problems in his 50s, he says. As a result, he often found himself having trouble staying awake during long drives on the Massachusetts Turnpike.\u003c/p>\n\u003cp>\"I would get groggy and feel like I've got to keep talking, open the window,\" Arnott says.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>His wife, Mary White, says being a passenger on those drives could be scary.\u003c/p>\n\u003cp>\"All of a sudden there'd be a change in the speed and I'd look over, and his eyes would be starting to close,\" she remembers.\u003c/p>\n\u003cp>White thought her husband might have sleep \u003ca href=\"http://www.nhlbi.nih.gov/health/health-topics/topics/sleepapnea\" target=\"_blank\">apnea\u003c/a>, which interferes with breathing. But Arnott was in denial. He figured he was free of most risk factors for apnea. He wasn't overweight, he didn't smoke or take sedatives, and he has always stayed in great shape.\u003c/p>\n\u003cp>\"I'm a runner. I've run for more than 40 years,\" he says. \"I used to do marathons. Now I just do 5- and 10-kilometer road races.\"\u003c/p>\n\u003cp>So his wife took the initiative. \"I asked him to see a doctor and he wouldn't,\" she says. In 2012, though, White persuaded him to take part in a sleep research study that paid for his participation, and took place at a sleep lab in Boston, not too far from the couple's home in Cambridge.\u003c/p>\n\u003cp>Doctors found a couple of problems. \"I've got what they call moderate obstructive sleep apnea,\" Arnott says. He also has a form of \u003ca href=\"http://www.ninds.nih.gov/disorders/restless_legs/detail_restless_legs.htm\" target=\"_blank\">restless leg syndrome\u003c/a> that causes him to kick during sleep.\u003c/p>\n\u003cp>Those conditions, along with his tendency to stay up late and wake up early, meant he wasn't getting enough quality sleep. And research in the past couple of decades has shown that's a problem even if you're not nodding off on the Massachusetts Turnpike.\u003c/p>\n\u003cp>Much of that research was done in the same sleep lab at Brigham and Women's Hospital where Arnott was diagnosed. The lab includes rooms that are completely isolated from the light, sounds and even vibrations of the outside world. As study participants sleep in these rooms, their brain waves, respiration, oxygen levels and other signs can be monitored from a central control room.\u003c/p>\n\u003cp>In highly controlled environments like this one, Czeisler and other researchers have shown that sleep affects everything from blood pressure to memory to metabolism.\u003c/p>\n\u003cp>\"Within 2 1/2 weeks we can take someone who is young, healthy and fit and put them in a pre-diabetic state just by putting them on an irregular schedule,\" Czeisler says.\u003c/p>\n\u003cp>Research also has shown a strong connection between sleep and the immune system, Czeisler says. \"People who are not getting sleep, if they're exposed to a virus like the adenovirus — that causes the common cold — they will have a 200 to 300 percent increased risk of actually catching a cold,\" he says.\u003c/p>\n\u003cp>Many studies suggest that a lack of sleep raises the risk of a heart attack or stroke. And most recently, Czeisler says, scientists have found \u003ca href=\"https://www.alzinfo.org/articles/poor-sleep-may-be-linked-to-alzheimers-disease/\" target=\"_blank\">evidence\u003c/a> that the brain actually needs sleep to stay healthy.\u003c/p>\n\u003cp>\"It's during sleep that we clear out many of the toxins that build up during wakefulness,\" Czeisler says. Among those toxins is beta-amyloid, which produces the sticky plaques that appear in the brains of people with Alzheimer's disease.\u003c/p>\n\u003cp>Most sleep disorders can be treated, but often they aren't. Arnott, the sleepy driver from Cambridge, didn't address his symptoms until his wife pushed him to take part in a sleep study.\u003c/p>\n\u003cfigure id=\"attachment_66824\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/cpap-machine_enl-d9fb74618f9efb012da832fa3f8d290dfbaa3fc2-e1440437424497.jpg\">\u003cimg class=\"size-thumbnail wp-image-66824\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/cpap-machine_enl-d9fb74618f9efb012da832fa3f8d290dfbaa3fc2-400x266.jpg\" alt=\"When worn at night, the mask of a CPAP (continuous positive airway pressure) machine delivers enough air pressure to keep the upper airway passages open. Blocked passages are behind the poor sleep and other symptoms associated with obstructive sleep apnea.\" width=\"400\" height=\"266\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">When worn at night, the mask of a CPAP (continuous positive airway pressure) machine delivers enough air pressure to keep the upper airway passages open. Blocked passages are behind the poor sleep and other symptoms associated with obstructive sleep apnea. \u003ccite>(Dr. P. Marazzi/Science Source)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"My whole clinic is full of patients who are brought in by their spouses,\" says Dr. Andrew Wellman, a sleep specialist at Harvard and Brigham and Women's who has cared for Arnott.\u003c/p>\n\u003cp>When Wellman is assessing a new patient, he asks a simple question: \"Do your eyelids get heavy when you'd prefer to be awake?\" If the answer is yes, that is a very specific indication that someone isn't getting enough sleep. Symptoms such as fatigue or feeling tired are less specific, and can have other causes, he says.\u003c/p>\n\u003cp>Much of Wellman's practice is devoted to sleep apnea, which affects about 1 in 3 adult men and becomes more common with age.\u003c/p>\n\u003cp>Wellman says a sleep apnea diagnosis usually requires an overnight sleep study to measure the flow of air in and out of the lungs. \"If that flow is diminished, then that is the primary measurement that we use to detect these sleep apnea events,\" he says.\u003c/p>\n\u003cp>The problem can be in the brain — a condition called central apnea. But more often the airway is getting blocked repeatedly during sleep, a disorder called obstructive sleep apnea.\u003c/p>\n\u003cp>Arnott has an unusual variant of obstructive sleep apnea, Wellman says. \"His airway actually collapses at the epiglottis, which is a structure just below the base of the tongue that prevents food from going down in the airway.\"\u003c/p>\n\u003cp>Regardless of the cause, the go-to treatment for sleep apnea is a continuous positive airway pressure (CPAP) machine. Arnott tried one for three months and hated it.\u003c/p>\n\u003cfigure id=\"attachment_66825\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/sleep-science-1_enl-501e441057efbfa64b8bcc5154019da948b34b5d-e1440437318243.jpg\">\u003cimg class=\"size-full wp-image-66825\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/sleep-science-1_enl-501e441057efbfa64b8bcc5154019da948b34b5d-e1440437318243.jpg\" alt='Instead of relying on forced air to keep his airway open when he sleeps, Arnott now wears this soft oral appliance at night. The device is more comfortable than CPAP, he says, and has decreased his apnea symptoms to \"negligible\" or \"mild.\"' width=\"1920\" height=\"1279\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Instead of relying on forced air to keep his airway open when he sleeps, Arnott now wears this soft oral appliance at night. The device is more comfortable than CPAP, he says, and has decreased his apnea symptoms to \"negligible\" or \"mild.\" \u003ccite>(M. Scott Bauer for NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"You have to have a mask on your face; you have a machine making noise all night, and you have to have electricity,\" he says. \"We hike. We go to places in the White Mountains of New Hampshire and Maine, where electricity is not always there.\"\u003c/p>\n\u003cp>Complaints like those are pretty common among people using CPAP machines, Wellman says. \"Somewhere around 50 percent of patients don't adhere to their therapy. Probably there are many people that don't even come to the sleep lab because they know they might get that breathing machine, and they don't want it.\"\u003c/p>\n\u003cp>One alternative is surgery to help keep the airway open. Another is an oral appliance that moves the lower jaw forward.\u003c/p>\n\u003cp>Arnott eventually switched to an oral appliance and has made a series of other changes. He sleeps on his side, which reduces apnea. He tries to get to bed at the same time each night. And he has begun doing yoga before bedtime, which he says helps with his restless leg syndrome.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Those steps have made a big difference, Arnott says. For one thing, he no longer falls asleep at the wheel. And now, he says, \"There are times on long trips when Mary actually says, 'I'm getting groggy. You drive.' \"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Snooze+Alert%3A+A+Sleep+Disorder+May+Be+Harming+Your+Body+And+Brain&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Drought Health Hazard: Not Enough Water to Keep Down Central Valley Dust",
"title": "Drought Health Hazard: Not Enough Water to Keep Down Central Valley Dust",
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"content": "\u003cp>It’s almond season in the Central Valley, when loud mechanical harvesters with long arms grip and shake the trees, knocking down the nuts.\u003c/p>\n\u003cp>But the process also sends up huge dust clouds. Farm machines and trucks make multiple trips on dirt roads between fields, and that creates dust, too.\u003c/p>\n\u003cp>The drought has been contributing to a dust bowl in Central Valley farm country. The dust, in turn, exacerbates the region's high rates of asthma. To keep dust down, farmers usually use a watering truck, spraying the roads to knock down the dust and comply with air pollution rules.\u003c/p>\n\u003cp>But now, in the fourth year of a crippling drought, the approach is changing.\u003c/p>\n\u003cp>It’s the job of the San Joaquin Valley Air Pollution Control District to oversee dust rules, and the district’s Ryan Hyashi says farmers have been very responsive. Now the district is trying to balance competing tensions.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"It’s potable water that they’re usually putting on these roads,\" Hyashi says. \"People don’t have water to drink, and we’re putting it on roadways. It sends a poor message\u003cstrong>.\"\u003c/strong>\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/220309181\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\u003cp>Instead, the air district is encouraging farmers to limit access to dirt roads, or cover them with things like gravel. If those options won’t work, farmers can now \u003ca href=\"http://www.valleyair.org/busind/comply/AssistanceDocuments/Dust_Control_Agricultural_Advisory.pdf\" target=\"_blank\">sign up for a program\u003c/a> to avoid enforcement penalties as long as they meet certain requirements, such as not being within 1,000 feet of a school or hospital.\u003c/p>\n\u003cp>\"[Farmers] want to do their part and be good stewards,” says Hayashi. But if there's no water for dust control, they may “just have no alternative.\"\u003c/p>\n\u003cp>But air quality advocates say the air district is essentially giving farmers a free pass to pollute.\u003c/p>\n\u003cp>\"When we see any relaxation in the rules, we get very nervous,\" says Kevin Hamilton, with the Central California Asthma Collaborative.\u003c/p>\n\u003cp>As we're talking, Hamilton watches a cloud of dust billow up on a farm road west of Fresno.\u003c/p>\n\u003cfigure id=\"attachment_65299\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/IMG_6792-e1440192126284.jpg\">\u003cimg class=\"size-thumbnail wp-image-65299\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/IMG_6792-400x300.jpg\" alt=\"Respiratory therapist Kevin Hamilton stands near an unplanted field on a dusty farm road west of Fresno.\" width=\"400\" height=\"300\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Respiratory therapist Kevin Hamilton stands near an unplanted field on a dusty farm road west of Fresno. \u003ccite>(Sasha Khokha)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"So here goes another truck with more dust coming up,\" he says. \"This is dangerous stuff. This is actually a health hazard.\"\u003c/p>\n\u003cp>Hamilton treats patients for asthma and says this kind of dust can travel for miles, ending up in people’s lungs. He criticized air regulators not only for the new dust guidelines, but also that they’re allowing \u003ca href=\"http://www.arb.ca.gov/msprog/ordiesel/faq/waterwelldrillingfaq.pdf\" target=\"_blank\">well-drilling rigs\u003c/a> from out of state that may have dirtier engines than California trucks.\u003c/p>\n\u003cp>\"I understand that we’re in an emergency,\" he says, \"but we’ve all fought so long to begin making progress here -- and I feel we are making progress. At this moment, it feels like we’re going to go backward again.\"\u003c/p>\n\u003cp>Just a few miles away, farmer Paul Betancourt says he doesn’t want his family breathing dusty air either. But he also doesn’t want the dust on his almond trees because it can cause mites. Watering down the roads on his farm, he says, means he uses fewer pesticides.\u003c/p>\n\u003cp>\"We want to use less chemicals on the farm,\" Betancourt says. \"You want us to use less chemicals on the farm. But in a year like this, when we’re really short of water, it’s balancing out how to keep the dust down.\"\u003c/p>\n\u003cp>Betancourt’s almond farm near the Fresno County town of Kerman has very fine, silty soil. For now, Betancourt says as long as he has water in his well, he’ll still periodically spray down the roads. Gravel is too expensive, and road oil just doesn’t work, he says.\u003c/p>\n\u003cp>“We need to use the water carefully and keep the dust down,” Betancourt said. “At this point, it’s still the most cost-effective way.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>He doesn’t plan to apply for the air district’s emergency drought relief programs. Farmers who do can avoid using water to control dust through Nov. 1. After that, the valley’s particulate matter season starts, and the air district says it will require farmers to use water to spray down roads again.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>It’s almond season in the Central Valley, when loud mechanical harvesters with long arms grip and shake the trees, knocking down the nuts.\u003c/p>\n\u003cp>But the process also sends up huge dust clouds. Farm machines and trucks make multiple trips on dirt roads between fields, and that creates dust, too.\u003c/p>\n\u003cp>The drought has been contributing to a dust bowl in Central Valley farm country. The dust, in turn, exacerbates the region's high rates of asthma. To keep dust down, farmers usually use a watering truck, spraying the roads to knock down the dust and comply with air pollution rules.\u003c/p>\n\u003cp>But now, in the fourth year of a crippling drought, the approach is changing.\u003c/p>\n\u003cp>It’s the job of the San Joaquin Valley Air Pollution Control District to oversee dust rules, and the district’s Ryan Hyashi says farmers have been very responsive. Now the district is trying to balance competing tensions.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"It’s potable water that they’re usually putting on these roads,\" Hyashi says. \"People don’t have water to drink, and we’re putting it on roadways. It sends a poor message\u003cstrong>.\"\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/220309181&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/220309181'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Instead, the air district is encouraging farmers to limit access to dirt roads, or cover them with things like gravel. If those options won’t work, farmers can now \u003ca href=\"http://www.valleyair.org/busind/comply/AssistanceDocuments/Dust_Control_Agricultural_Advisory.pdf\" target=\"_blank\">sign up for a program\u003c/a> to avoid enforcement penalties as long as they meet certain requirements, such as not being within 1,000 feet of a school or hospital.\u003c/p>\n\u003cp>\"[Farmers] want to do their part and be good stewards,” says Hayashi. But if there's no water for dust control, they may “just have no alternative.\"\u003c/p>\n\u003cp>But air quality advocates say the air district is essentially giving farmers a free pass to pollute.\u003c/p>\n\u003cp>\"When we see any relaxation in the rules, we get very nervous,\" says Kevin Hamilton, with the Central California Asthma Collaborative.\u003c/p>\n\u003cp>As we're talking, Hamilton watches a cloud of dust billow up on a farm road west of Fresno.\u003c/p>\n\u003cfigure id=\"attachment_65299\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/IMG_6792-e1440192126284.jpg\">\u003cimg class=\"size-thumbnail wp-image-65299\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/IMG_6792-400x300.jpg\" alt=\"Respiratory therapist Kevin Hamilton stands near an unplanted field on a dusty farm road west of Fresno.\" width=\"400\" height=\"300\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Respiratory therapist Kevin Hamilton stands near an unplanted field on a dusty farm road west of Fresno. \u003ccite>(Sasha Khokha)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"So here goes another truck with more dust coming up,\" he says. \"This is dangerous stuff. This is actually a health hazard.\"\u003c/p>\n\u003cp>Hamilton treats patients for asthma and says this kind of dust can travel for miles, ending up in people’s lungs. He criticized air regulators not only for the new dust guidelines, but also that they’re allowing \u003ca href=\"http://www.arb.ca.gov/msprog/ordiesel/faq/waterwelldrillingfaq.pdf\" target=\"_blank\">well-drilling rigs\u003c/a> from out of state that may have dirtier engines than California trucks.\u003c/p>\n\u003cp>\"I understand that we’re in an emergency,\" he says, \"but we’ve all fought so long to begin making progress here -- and I feel we are making progress. At this moment, it feels like we’re going to go backward again.\"\u003c/p>\n\u003cp>Just a few miles away, farmer Paul Betancourt says he doesn’t want his family breathing dusty air either. But he also doesn’t want the dust on his almond trees because it can cause mites. Watering down the roads on his farm, he says, means he uses fewer pesticides.\u003c/p>\n\u003cp>\"We want to use less chemicals on the farm,\" Betancourt says. \"You want us to use less chemicals on the farm. But in a year like this, when we’re really short of water, it’s balancing out how to keep the dust down.\"\u003c/p>\n\u003cp>Betancourt’s almond farm near the Fresno County town of Kerman has very fine, silty soil. For now, Betancourt says as long as he has water in his well, he’ll still periodically spray down the roads. Gravel is too expensive, and road oil just doesn’t work, he says.\u003c/p>\n\u003cp>“We need to use the water carefully and keep the dust down,” Betancourt said. “At this point, it’s still the most cost-effective way.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>He doesn’t plan to apply for the air district’s emergency drought relief programs. Farmers who do can avoid using water to control dust through Nov. 1. After that, the valley’s particulate matter season starts, and the air district says it will require farmers to use water to spray down roads again.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Child Who Had Camped at Yosemite Recovering From the Plague",
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"content": "\u003cp>A child from Los Angeles County is recovering from a case of the plague, state health officials reported Thursday.\u003c/p>\n\u003cp>The child was hospitalized after visiting Stanislaus National Forest and camping at Yosemite National Park's Crane Flat Campground. No one else in the child's group became sick, officials said.\u003c/p>\n\u003cp>No other information about the child was released.\u003c/p>\n\u003cp>\"Cases of plague in California are very rare,\" said Vicki Kramer, chief of the vector-borne disease section of the California Department of Public Health (CDPH). \"Every year, however, we do detect animals with plague in California, particularly at higher elevations. We've found it in 49 [of California's 58] counties.\"\u003c/p>\n\u003cp>Plague is an infectious bacterial disease carried by squirrels, chipmunks and other wild rodents as well as their fleas. The fleas \"prefer to live on rodents,\" Kramer said, so generally don't pose a threat to people.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"It's only when the rodents die that they may seek an alternative host, such as a person,\" she said. But a person would need to come into very close contact with the rodent to become infected.\u003c/p>\n\u003cp>To avoid this close contact, keep your distance from wildlife.\u003c/p>\n\u003cp>Dr. Danielle Buttke is with the U.S. Public Health Service and is currently in Yosemite investigating the outbreak, along with CDPH and Centers for Disease Control and Prevention officials.\u003c/p>\n\u003cp>\"Never touch or feed wildlife,\" she said. \"Don't try to approach them, give them their space.\" In particular, steer clear of animals acting strangely, because it is more likely that the animal is sick.\u003c/p>\n\u003cp>Other protective measures that \u003ca href=\"http://Crane%20Flat%20Campground%20at\" target=\"_blank\">CDPH recommends \u003c/a>include:\u003c/p>\n\u003cul>\n\u003cli>Never touch sick or dead rodents\u003c/li>\n\u003cli>Avoid walking, hiking or camping near rodent burrows\u003c/li>\n\u003cli>Wear long pants tucked into socks or boot tops to reduce exposure to fleas\u003c/li>\n\u003cli>Spray insect repellent containing DEET on socks and pant cuffs to reduce exposure to fleas\u003c/li>\n\u003cli>Keep wild rodents out of homes, trailers, and outbuildings and away from pets\u003c/li>\n\u003c/ul>\n\u003cp>The initial symptoms of plague include high fever, chills, nausea, weakness and swollen glands. Plague is treatable in the early stages with prompt administration of antibiotics.\u003c/p>\n\u003cp>The CDPH says there have been no known cases of human-to-human infection in California since 1924. The last human case of plague in the state was in 2006.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Sasha Khokha and Kerry Klein contributed to this report. \u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"It's only when the rodents die that they may seek an alternative host, such as a person,\" she said. But a person would need to come into very close contact with the rodent to become infected.\u003c/p>\n\u003cp>To avoid this close contact, keep your distance from wildlife.\u003c/p>\n\u003cp>Dr. Danielle Buttke is with the U.S. Public Health Service and is currently in Yosemite investigating the outbreak, along with CDPH and Centers for Disease Control and Prevention officials.\u003c/p>\n\u003cp>\"Never touch or feed wildlife,\" she said. \"Don't try to approach them, give them their space.\" In particular, steer clear of animals acting strangely, because it is more likely that the animal is sick.\u003c/p>\n\u003cp>Other protective measures that \u003ca href=\"http://Crane%20Flat%20Campground%20at\" target=\"_blank\">CDPH recommends \u003c/a>include:\u003c/p>\n\u003cul>\n\u003cli>Never touch sick or dead rodents\u003c/li>\n\u003cli>Avoid walking, hiking or camping near rodent burrows\u003c/li>\n\u003cli>Wear long pants tucked into socks or boot tops to reduce exposure to fleas\u003c/li>\n\u003cli>Spray insect repellent containing DEET on socks and pant cuffs to reduce exposure to fleas\u003c/li>\n\u003cli>Keep wild rodents out of homes, trailers, and outbuildings and away from pets\u003c/li>\n\u003c/ul>\n\u003cp>The initial symptoms of plague include high fever, chills, nausea, weakness and swollen glands. Plague is treatable in the early stages with prompt administration of antibiotics.\u003c/p>\n\u003cp>The CDPH says there have been no known cases of human-to-human infection in California since 1924. The last human case of plague in the state was in 2006.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Sasha Khokha and Kerry Klein contributed to this report. \u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"id": "commonwealth-club",
"title": "Commonwealth Club of California Podcast",
"info": "The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.",
"airtime": "THU 10pm, FRI 1am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg",
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"meta": {
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"source": "Commonwealth Club of California"
},
"link": "/radio/program/commonwealth-club",
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"google": "https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw",
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},
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"id": "forum",
"title": "Forum",
"tagline": "The conversation starts here",
"info": "KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.",
"airtime": "MON-FRI 9am-11am, 10pm-11pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED Forum with Mina Kim and Alexis Madrigal",
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"order": 9
},
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"id": "freakonomics-radio",
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"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/freakonomicsRadio.png",
"officialWebsiteLink": "http://freakonomics.com/",
"airtime": "SUN 1am-2am, SAT 3pm-4pm",
"meta": {
"site": "radio",
"source": "WNYC"
},
"link": "/radio/program/freakonomics-radio",
"subscribe": {
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"apple": "https://itunes.apple.com/us/podcast/freakonomics-radio/id354668519",
"tuneIn": "https://tunein.com/podcasts/WNYC-Podcasts/Freakonomics-Radio-p272293/",
"rss": "https://feeds.feedburner.com/freakonomicsradio"
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},
"fresh-air": {
"id": "fresh-air",
"title": "Fresh Air",
"info": "Hosted by Terry Gross, \u003cem>Fresh Air from WHYY\u003c/em> is the Peabody Award-winning weekday magazine of contemporary arts and issues. One of public radio's most popular programs, Fresh Air features intimate conversations with today's biggest luminaries.",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=214089682&at=11l79Y&ct=nprdirectory",
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"rss": "https://feeds.npr.org/381444908/podcast.xml"
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"info": "A live production of NPR and WBUR Boston, in collaboration with stations across the country, Here & Now reflects the fluid world of news as it's happening in the middle of the day, with timely, in-depth news, interviews and conversation. Hosted by Robin Young, Jeremy Hobson and Tonya Mosley.",
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"rss": "https://feeds.npr.org/510051/podcast.xml"
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},
"hidden-brain": {
"id": "hidden-brain",
"title": "Hidden Brain",
"info": "Shankar Vedantam uses science and storytelling to reveal the unconscious patterns that drive human behavior, shape our choices and direct our relationships.",
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"airtime": "SUN 7pm-8pm",
"meta": {
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"source": "NPR"
},
"link": "/radio/program/hidden-brain",
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},
"how-i-built-this": {
"id": "how-i-built-this",
"title": "How I Built This with Guy Raz",
"info": "Guy Raz dives into the stories behind some of the world's best known companies. How I Built This weaves a narrative journey about innovators, entrepreneurs and idealists—and the movements they built.",
"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/howIBuiltThis.png",
"officialWebsiteLink": "https://www.npr.org/podcasts/510313/how-i-built-this",
"airtime": "SUN 7:30pm-8pm",
"meta": {
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},
"link": "/radio/program/how-i-built-this",
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"npr": "https://rpb3r.app.goo.gl/3zxy",
"apple": "https://itunes.apple.com/us/podcast/how-i-built-this-with-guy-raz/id1150510297?mt=2",
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},
"hyphenacion": {
"id": "hyphenacion",
"title": "Hyphenación",
"tagline": "Where conversation and cultura meet",
"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/03/Hyphenacion_FinalAssets_PodcastTile.png",
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"officialWebsiteLink": "/podcasts/hyphenacion",
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"order": 15
},
"link": "/podcasts/hyphenacion",
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"spotify": "https://open.spotify.com/show/2p3Fifq96nw9BPcmFdIq0o?si=39209f7b25774f38",
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},
"jerrybrown": {
"id": "jerrybrown",
"title": "The Political Mind of Jerry Brown",
"tagline": "Lessons from a lifetime in politics",
"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-Political-Mind-of-Jerry-Brown-Podcast-Tile-703x703-1.jpg",
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"officialWebsiteLink": "/podcasts/jerrybrown",
"meta": {
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"order": 18
},
"link": "/podcasts/jerrybrown",
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}
},
"latino-usa": {
"id": "latino-usa",
"title": "Latino USA",
"airtime": "MON 1am-2am, SUN 6pm-7pm",
"info": "Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/latinoUsa.jpg",
"officialWebsiteLink": "http://latinousa.org/",
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},
"link": "/radio/program/latino-usa",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=79681317&at=11l79Y&ct=nprdirectory",
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"rss": "https://feeds.npr.org/510016/podcast.xml"
}
},
"marketplace": {
"id": "marketplace",
"title": "Marketplace",
"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
"airtime": "MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Marketplace-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.marketplace.org/",
"meta": {
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"source": "American Public Media"
},
"link": "/radio/program/marketplace",
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"rss": "https://feeds.publicradio.org/public_feeds/marketplace-pm/rss/rss"
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},
"masters-of-scale": {
"id": "masters-of-scale",
"title": "Masters of Scale",
"info": "Masters of Scale is an original podcast in which LinkedIn co-founder and Greylock Partner Reid Hoffman sets out to describe and prove theories that explain how great entrepreneurs take their companies from zero to a gazillion in ingenious fashion.",
"airtime": "Every other Wednesday June 12 through October 16 at 8pm (repeats Thursdays at 2am)",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Masters-of-Scale-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://mastersofscale.com/",
"meta": {
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"source": "WaitWhat"
},
"link": "/radio/program/masters-of-scale",
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"apple": "http://mastersofscale.app.link/",
"rss": "https://rss.art19.com/masters-of-scale"
}
},
"mindshift": {
"id": "mindshift",
"title": "MindShift",
"tagline": "A podcast about the future of learning and how we raise our kids",
"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED MindShift: How We Will Learn",
"officialWebsiteLink": "/mindshift/",
"meta": {
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"source": "kqed",
"order": 12
},
"link": "/podcasts/mindshift",
"subscribe": {
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
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}
},
"morning-edition": {
"id": "morning-edition",
"title": "Morning Edition",
"info": "\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. Hosts Steve Inskeep, David Greene and Rachel Martin bring you the latest breaking news and features to prepare you for the day.",
"airtime": "MON-FRI 3am-9am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Morning-Edition-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.npr.org/programs/morning-edition/",
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"link": "/radio/program/morning-edition"
},
"onourwatch": {
"id": "onourwatch",
"title": "On Our Watch",
"tagline": "Deeply-reported investigative journalism",
"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/On-Our-Watch-Podcast-Tile-703x703-1.jpg",
"imageAlt": "On Our Watch from NPR and KQED",
"officialWebsiteLink": "/podcasts/onourwatch",
"meta": {
"site": "news",
"source": "kqed",
"order": 11
},
"link": "/podcasts/onourwatch",
"subscribe": {
"apple": "https://podcasts.apple.com/podcast/id1567098962",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM2MC9wb2RjYXN0LnhtbD9zYz1nb29nbGVwb2RjYXN0cw",
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"rss": "https://feeds.npr.org/510360/podcast.xml"
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},
"on-the-media": {
"id": "on-the-media",
"title": "On The Media",
"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
"airtime": "SUN 2pm-3pm, MON 12am-1am",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/onTheMedia.png",
"officialWebsiteLink": "https://www.wnycstudios.org/shows/otm",
"meta": {
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"source": "wnyc"
},
"link": "/radio/program/on-the-media",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/on-the-media/id73330715?mt=2",
"tuneIn": "https://tunein.com/radio/On-the-Media-p69/",
"rss": "http://feeds.wnyc.org/onthemedia"
}
},
"pbs-newshour": {
"id": "pbs-newshour",
"title": "PBS NewsHour",
"info": "Analysis, background reports and updates from the PBS NewsHour putting today's news in context.",
"airtime": "MON-FRI 3pm-4pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/PBS-News-Hour-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.pbs.org/newshour/",
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"source": "pbs"
},
"link": "/radio/program/pbs-newshour",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/pbs-newshour-full-show/id394432287?mt=2",
"tuneIn": "https://tunein.com/radio/PBS-NewsHour---Full-Show-p425698/",
"rss": "https://www.pbs.org/newshour/feeds/rss/podcasts/show"
}
},
"perspectives": {
"id": "perspectives",
"title": "Perspectives",
"tagline": "KQED's series of daily listener commentaries since 1991",
"info": "KQED's series of daily listener commentaries since 1991.",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/01/Perspectives_Tile_Final.jpg",
"imageAlt": "KQED Perspectives",
"officialWebsiteLink": "/perspectives/",
"meta": {
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"source": "kqed",
"order": 14
},
"link": "/perspectives",
"subscribe": {
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"npr": "https://www.npr.org/podcasts/432309616/perspectives",
"rss": "https://ww2.kqed.org/perspectives/category/perspectives/feed/",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly93dzIua3FlZC5vcmcvcGVyc3BlY3RpdmVzL2NhdGVnb3J5L3BlcnNwZWN0aXZlcy9mZWVkLw"
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},
"planet-money": {
"id": "planet-money",
"title": "Planet Money",
"info": "The economy explained. Imagine you could call up a friend and say, Meet me at the bar and tell me what's going on with the economy. Now imagine that's actually a fun evening.",
"airtime": "SUN 3pm-4pm",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/planetmoney.jpg",
"officialWebsiteLink": "https://www.npr.org/sections/money/",
"meta": {
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"source": "npr"
},
"link": "/radio/program/planet-money",
"subscribe": {
"npr": "https://rpb3r.app.goo.gl/M4f5",
"apple": "https://itunes.apple.com/us/podcast/planet-money/id290783428?mt=2",
"tuneIn": "https://tunein.com/podcasts/Business--Economics-Podcasts/Planet-Money-p164680/",
"rss": "https://feeds.npr.org/510289/podcast.xml"
}
},
"politicalbreakdown": {
"id": "politicalbreakdown",
"title": "Political Breakdown",
"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
"airtime": "THU 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Political-Breakdown-2024-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED Political Breakdown",
"officialWebsiteLink": "/podcasts/politicalbreakdown",
"meta": {
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"source": "kqed",
"order": 5
},
"link": "/podcasts/politicalbreakdown",
"subscribe": {
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"amazon": "https://music.amazon.com/podcasts/e0c2d153-ad36-4c8d-901d-f1da6a724824/political-breakdown",
"npr": "https://www.npr.org/podcasts/572155894/political-breakdown",
"stitcher": "https://www.stitcher.com/podcast/kqed/political-breakdown",
"spotify": "https://open.spotify.com/show/07RVyIjIdk2WDuVehvBMoN",
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