Tuesday, March 3, 2009

Doctors: No definitive answers on flu deaths among young

he majority of flu deaths strike the elderly and people with pre-existing health problems. But flu also affects kids with no known medical problems and can send them into critical condition, or even death.

This flu season started slowly, and doctors anticipate the peak will occur this month or April. Dr. Len Horovitz, a pulmonary specialist at Lenox Hill Hospital in New York, has been giving booster shots to patients who were vaccinated early in the season, September or October.

"There's a decline in antibody levels, so we try to give a booster," Horovitz said. "I've been talking to immunologists [about] getting a booster-- there's no downside to it."

Although doctors advise that nearly everyone should get a flu shot, skepticism about the severity of the illness and questions about shot's effectiveness persist.

The Journal of the American Medical Association released three studies about the flu Monday. One reports that some flu viruses circulating during the 2007-2008 season were resistant to Tamiflu, an antiviral flu medicine. But those who had the strains resistant to Tamiflu did not get sicker than other patients. Read more on the rise in Tamiflu-resistant flu

During the 2007-08 flu season, Centers for Disease Control and Prevention recorded 86 pedatric deaths from flu-related complications.

The virus causes inflammation throughout the body and disturbs the functions of the body, including breathing.

Deaths from the flu are "most likely respiratory-related," said Doug Hardy, an infectious diseases specialist at the University of Texas-Southwestern Medical Center in Dallas. "Flu can cause heart inflammation, lung inflammation." Co-infections also play a role.

Four years ago, Martin McGowan, 15, came home after trying out for his high school baseball team and slumped in front of the television. His mother, Diane McGowan thought it was unusual for her athletic teenage son.

"He just wasn't his active self," she said. "He usually reminded us of Tigger, bouncing all over the place."

He went to bed that night complaining of flu-like symptoms.

"He had a temperature," said McGowan of Nazareth, Pennsylvania. "It was 102. I knew the drill, give them ibuprofen or Motrin, give them something for the pain, and call the doctor the next day and see how it goes. That's the normal case."

That night, Martin vomited a couple of times, complained of pains in his legs and his lips were turning white. They rushed to the emergency room.

The doctors said he had the flu.

"Even at that point, I didn't understand how sick my child was in the emergency room," McGowan said. "Influenza doesn't come across like that."

The day before, Martin had gone running, which had irritated his leg muscles. The condition in his leg had developed into compartment syndrome, which limits blood circulation and causes leg pains. Doctors said he needed surgery as soon as possible.

While he was wheeled into the operating room, Martin turned to say: "Mom, don't cry. It's going to be OK."

Martin died in the operating room.

"To hear that, it's heart-wrenching," his mother said. "The autopsy confirms it's influenza, it rips your heart out."

"He was a very healthy, active 15-year-old. He hadn't been feeling well for one day. It hit him hard. It hit him like a lightning bolt. Within 15 hours, he was gone," she said.

Cases like Martin's have baffled scientists, who usually see between 50 and 150 pediatric flu deaths a year in the United States.

Typically half of the flu deaths occur in children who have degenerative heart or lung disease or immune risk factors, but the other half are seemingly healthy.

"There isn't a good understanding of why that happens," said Dr. John Treanor, professor of medicine and of microbiology and immunology at the University of Rochester School of Medicine. "There's speculation that these children, for genetic reasons, had unusual immune response to the flu, resulting in deaths."

A person infected with the flu has weakened lungs and immune system, and could contract bacterial pneumonia or methicillin-resistant Staphylococcus aureus, or MRSA.

Of the nine pediatric deaths reported this season, bacterial co-infections were confirmed in six. Four of them also had staphylococcus infections.

"That seems to be where a lot of people end up dying," Hardy said. "It's a combined killer with flu and bacterial pneumonia. More of the people who do die have co-infections. You don't have to be a weakened person without medical problems to die from the flu."

Diane McGowan joined a group, Families Fighting Flu and started campaigning for the CDC to extend its flu vaccine guidelines, which had previously recommended annual shots for children between the 6 month and 5 years. Beginning with this flu season, the agency extended recommendations to 18-year-olds.

"It's very sad to know that just a simple flu vaccination could've helped him (Martin)," McGowan said.

The CDC estimates that more than 200,000 people are hospitalized and about 36,000 people die every year from flu complications.

Study: 7.3 million in U.S. prison system in '07

he U.S. correctional population -- those in jail, prison, on probation or on parole -- totaled 7.3 million, or 1 in every 31 adults.

The Pew Center on the States compiled the information from Justice Department and Census Bureau statistics.

America's prison population has skyrocketed over the past quarter century. In 1982, 1 in 77 adults were in the correctional system in one form or another, totaling 2.2 million people.

The United States has 5 percent of the world's population, but 25 percent of the world's prison inmates, the center said.

The numbers vary widely by race and gender.

"Black adults are four times as likely as whites and nearly 2.5 times as likely as Hispanics to be under correctional control. One in 11 black adults -- 9.2 percent -- was under correctional supervision at year-end 2007," the report said. "And although the number of female offenders continues to grow, men of all races are under correctional control at a rate five times that of women."

There are also wide differences depending on the state. Georgia tops the nation, with 1 in 13 adults in the state's corrections system, while in New Hampshire the figure is 1 in 88. Southern states tended to have higher rates, with Plains and rural Northeastern states coming in lower.

"State policy choices are responsible for creating this mess and state policy choices can get us out," said Adam Gelb, director of the Public Safety Performance Project for the Pew Center on the States. "There are two things, and two things only that determine the size and cost of the prison system."

Dealing out longer sentences and putting more people behind bars have been the hallmarks of Southern states, he said.

America's record prison population has had a huge budgetary effect, according to the report, with increased corrections spending outstripping everything at the state level except for Medicaid.

Gelb said prison costs 22 times more than community-based corrections.

"If you talk to judges and prosecutors practically anywhere in this country, they will tell you if they had stronger community corrections, they wouldn't have to send so many people [to prison] for so many low-level offenses," he said.

For California, it has meant overcrowded prisons. In February, federal judges tentatively ruled that California must reduce the number of inmates in its prison system by up to 40 percent to stop a constitutional violation of prisoners' rights.

Implementing the court's ruling would result in up to 58,000 prisoners being released, said Matthew Cate, California's corrections and rehabilitation secretary, describing it as a threat to public safety.

The Pew Center on the States, through its Public Safety Performance Project, says it promotes "fiscally sound, data-driven policies and practices in sentencing and corrections that protect public safety, hold offenders accountable, and control corrections costs."

The California Catastrophe from 1,000 Feet

Tonight, Charlie Gibson anchors World News from California, which has been on the front lines of the recession. ABC's Stu Schutzman reports from Los Angeles:

From 1,000 feet above Southern California's so called Inland Empire, you can see the ravages of this recession first hand. Town after town, Pomona, Covina, West Covina, Ontario and on to San Bernardino, the evidence is stunning. Empty parking lots at the local Ikea or Target. People who flocked here believing it was the land of ultimate opportunity are now packing up the pick-up in the front yard heading somewhere -- anywhere there's a job they'll tell you.

But the most striking scenes from the air are the backyard swimming pools. In some neighborhoods, pool after pool on street after street are the same danky, dark green hue; a sure sign of foreclosure. State officials periodically fly over, as we did this morning, cataloging the areas of high concentration. Teams of exterminators and fumigators are then dispatched to prevent these once thriving neighborhoods from turning into public health hazards. It's a measure of where this place was and how far down it has gone.

People here blame incompetent government, greed and some even blame themselves for believing the bubble would never burst. We talked to a group of Californians today all facing hard times. What some of them have to say could be quite instructive for the rest of us. Tune in.

The World Newser

Rush Limbaugh Versus His Own Party

March 02, 2009 6:07 PM

Who is the 'de facto' leader of the Republican Party? Is it the chairman of the party, the newly instated Michael Steele? Is it one of the party's leader in Congress, John Boehner or Eric Cantor? Is it John McCain? Or is it Rush?

There was some inner party friction today. ABC News' Steve Portnoy summed it up in The Note: "The nation’s most listened-to conservative talk radio host, Rush Limbaugh, practically declared war on the newly-elected leader of the Republican National Committee today, following a television interview in which the RNC chair called Limbaugh’s show “incendiary” and “ugly.” In the interview that aired Saturday, Michael Steele, who became the Republican chairman last month, took umbrage when CNN’s D.L. Hughley suggested that Limbaugh is the “de facto leader of the Republican party.” “No, he’s not,” Steele said. “I’m the de facto leader of the Republican party.” Referring to Limbaugh’s statements that the talk show host wants President Obama “to fail,” Steele said, “Let’s put it into context here. Rush Limbaugh is an entertainer. Yes, it’s incendiary. Yes, it’s ugly.” Limbaugh responded today with an on-air diatribe against the new party chairman that ran nearly 20 minutes, alleging that Steele is more interested in being a “talking head” on television than leading the party to electoral success. “I hope the RNC chairman realizes he’s not a talking head pundit,” Limbaugh said. “It’s time, Mr. Steele, for you to go behind the scenes and start doing the work that you were elected to do, instead of trying to be some talking head media star, which you’re having a tough time pulling off.”"