New Study Finds Positive Return on Investment for States That Invest in Quit Smoking Treatments

/PRNewswire/ -- A new study released today by the American Lung Association, and conducted by researchers at Penn State University, finds that helping smokers quit not only saves lives but also offers favorable economic benefits to states. The study, titled Smoking Cessation: the Economic Benefits, provides a nationwide cost-benefit analysis that compares the costs to society of smoking with the economic benefits of states providing cessation (quit-smoking) coverage. The study comes at an important time, as important cessation benefit provisions are being implemented at the federal and state levels as a result of healthcare reform legislation.

Each year, tobacco use kills 393,000 people in America, and this new study identifies significant and staggering costs directly attributable to death and disease caused by smoking. For example, the study finds that smoking results in costs to the U.S. economy of more than $301 billion. This includes workplace productivity losses of $67.5 billion, costs of premature death at $117 billion, and direct medical expenditures of $116 billion.

The study also calculates the combined medical and premature death costs and workplace productivity losses per pack of cigarettes. The nationwide average retail pack of cigarettes is $5.51. The costs and workplace productivity losses nationwide equal $18.05--more than 300 percent the average retail price of a cigarette pack.

"This study spells out in dollars and cents the great potential economic benefits to states of helping smokers quit. We urge the District of Columbia and all states to offer full coverage of clinically proven cessation treatments for smokers, which will not only save lives but also money," Charles D. Connor, President and CEO of the American Lung Association.

Smoking is the number one preventable cause of illness and death in the United States and surveys show that 70 percent of tobacco users want to quit. Quitting can often take several attempts before a smoker is successful. Using evidence-based treatments increases smokers' chances of quitting - but many smokers don't have access to or don't know about what kind of treatments are available to them.

In addition to identifying the staggering costs of smoking to the U.S. economy, this new study now provides state governments with compelling economic reasons to help smokers quit. For example, the study finds that if states were to invest in comprehensive smoking cessation benefits, each would receive, on average, a 26 percent return on investment. In other words, for every dollar spent on helping smokers quit, states will see on average a return of $1.26.

Some states (and the District of Columbia) would see a higher return than others. For example, the study finds that the District of Columbia would receive the highest return on its investment. For every dollar spent on smoking cessation treatments, it would see a return of $1.94. Other states with higher than average returns include the following: Louisiana ($1.47), Massachusetts ($1.43), Maine ($1.41), Ohio ($1.41) and North Dakota ($1.41). State specific data can be found at www.lungusa.org/cessationbenefits.

The study derives these economic benefits by considering lower medical costs due to fewer people smoking, increased productivity in the workplace and reduced absenteeism and premature death due to smoking.

Some of the highest rates of smoking are found among people enrolled in Medicaid, the joint federal and state health program for low-income people. The American Lung Association urges every state to provide all Medicaid recipients and state employees with comprehensive, easily accessible tobacco cessation benefits. A comprehensive cessation benefit includes all seven medications and three types of counseling recommended by the U.S. Public Health Service for tobacco cessation. Only six states now provide comprehensive coverage for Medicaid recipients: Indiana, Massachusetts, Minnesota, Nevada, Oregon and Pennsylvania.

The Lung Association also recommends that private insurance plans and employers offer comprehensive cessation coverage and encourages states to require them to cover these treatments. Only seven states have such requirements now: Colorado, Maryland, New Jersey, New Mexico, North Dakota, Oregon and Rhode Island.

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Dengue Fever and Insect-Borne Infections Emerging as Public Health Problem in Areas of the United States

/PRNewswire/ -- Several cases of dengue fever, a potentially fatal viral disease transmitted by the bite of urban dwelling Aedes aegypti and Aedes albopictus mosquitoes, have recently been reported in the continental United States. Prevalent in Central America and the Caribbean, dengue fever's most common symptoms include fever, chills, headache, and body aches lasting several days. The disease's more threatening form, dengue hemorrhagic fever, can cause internal bleeding, loss of blood pressure, and death. Over the past five years, outbreaks of both forms of the disease have been reported in Texas and Florida.

Despite the threat of further introduction of dengue into the mainland United States, as well as the risk of introduction of additional vector-borne diseases, President Obama's 2011 fiscal budget reduces to zero the funding to support the vector-borne infectious disease program at the Centers for Disease Control and Prevention (CDC), the only national program that focuses of detection and outbreak control of vector-borne diseases including dengue, plague, viral encephalitis and Lyme disease.

"At the American Society for Tropical Medicine and Hygiene, we are concerned that the currently proposed 2011 budget would not provide sufficient funding for this important government function. One in fifty people in the world dies of an illness acquired from an insect bite, and tens of thousands of Americans already fall ill each year from infections transmitted by mosquitoes and ticks. Insects do not respect state borders, and neither can our national response," said Edward T. Ryan, M.D., President, American Society of Tropical Medicine and Hygiene (ASTMH). "Although we recognize and applaud the need to constantly scan the Federal budget to identify outdated or unnecessary programs, eliminating the CDC's vector-borne infectious disease program is not one of these areas. The proposed cuts to this program would be shortsighted, and would harm the health of the American people."

Considering dengue as an example, beginning in the 1980s, dengue fever re-emerged as a widespread tropical infection throughout Central America and the Caribbean, pervasive in Cuba, the Dominican Republic, and Puerto Rico. Tens of thousands of cases of dengue and several thousand dengue hemorrhagic fever cases occur annually across Central America and the Caribbean. The disease's reach is not limited to these regions, however. In 2005, dengue fever emerged in Brownsville, TX and in 2009, the disease returned to the Florida Keys, after a 75-year hiatus. These recent outbreaks of dengue and dengue hemorrhagic fever suggest that the disease could spread and become a health threat in major Gulf Coast cities such as Corpus Christi, Houston, New Orleans, Biloxi, Mobile, Pensacola and Tampa, as well as in less populated areas.

The World Health Organization estimates that 2.5 billion people (two fifths the world's population), risk contracting dengue, and that there may be as many as 50 million cases of dengue fever every year. The disease disproportionately affects poor populations, whose low-quality living conditions and link to poor sanitation are conducive to the establishment of mosquito breeding sites, and increase this demographics' contact with Aedes mosquitoes. Currently, there is no vaccine approved to protect humans against dengue, and the most effective protective measures are those to avoid mosquito bites (wearing bug repellent, spraying pesticides, and dumping any standing water). If infected, the early recognition and prompt treatment can help lower the risk of developing severe disease complications.

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CDC: Swine Flu Update April 27, 2009

Human cases of swine influenza A (H1N1) virus infection have been identified in the United States. Human cases of swine influenza A (H1N1) virus infection also have been identified internationally. The current U.S. case count is provided below.

U.S. Human Cases of Swine Flu Infection
(As of April 27, 2009 1:00 PM ET)

State	# of laboratory confirmed cases
California	7 cases
Kansas	2 cases
New York City	28 cases
Ohio	1 case
Texas	2 cases
TOTAL COUNT	40 cases

An investigation and response effort surrounding the outbreak of swine flu is ongoing.

CDC is working very closely with officials in states where human cases of swine influenza A (H1N1) have been identified, as well as with health officials in Mexico, Canada and the World Health Organization. This includes deploying staff domestically and internationally to provide guidance and technical support.

CDC activated its Emergency Operations Center to coordinate the agency's response to this emerging health threat and yesterday the Secretary of the Department Homeland Security, Janet Napolitano, declared a public health emergency in the United States.

This will allow funds to be released to support the public health response. CDC's goals during this public health emergency are to reduce transmission and illness severity, and provide information to assist health care providers, public health officials and the public in addressing the challenges posed by this newly identified influenza virus. To this end, CDC has issued a number of interim guidance documents in the past 24 hours. In addition, CDC's Division of the Strategic National Stockpile (SNS) is releasing one-quarter of its antiviral drugs, personal protective equipment, and respiratory protection devices to help states respond to the outbreak. Laboratory testing has found the swine influenza A (H1N1) virus susceptible to the prescription antiviral drugs oseltamivir and zanamivir. This is a rapidly evolving situation and CDC will provide updated guidance and new information as it becomes available.

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FDA Launches Pilot Program To Improve the Safety of Drugs and Active Drug Ingredients Produced Outside the United States

The U.S. Food and Drug Administration today announced the launch of a voluntary pilot program that would help promote the safety of drugs and active drug ingredients produced outside the United States.

The FDA plans to select 100 applicants to participate in the Secure Supply Chain pilot program. To qualify, applicants will need to meet the pilot program's criteria, including a requirement that they maintain control over the drug products from the time of manufacture through entry into the country.

The goal of the pilot is to allow FDA to determine the practicality of developing a secure supply chain program. Such a program would assist the agency in its efforts to prevent the importation of drugs that do not comply with applicable FDA requirements by allowing the agency to focus its resources on foreign-produced drugs that fall outside the program and that may not be compliant. It will also expedite the entry of products meeting the pilot's criteria into the United States. The pilot was developed with input from U.S. Customs and Border Protection and other stakeholders. Information about the pilot appears in a Federal Register notice that went on display today.

"This initiative creates incentives for drug makers to develop and maintain secure supply chains," said Deborah Autor, Director of the Office of Compliance in FDA's Center for Drug Evaluation and Research. "This is one of several agency initiatives to enhance drug product safety."

Each applicant may designate up to five drugs for selection in the pilot program. To qualify, applicants will need to meet the pilot's criteria, including a requirement that they maintain control over the drugs from the time of manufacture through entry into the United States. A secure supply chain will help mitigate risks such as contamination and counterfeiting. Applications for participation in the pilot program will be processed in the order received.

"With the increase of drug products produced outside the United States, it is critical that the FDA concentrate its resources on companies that pose the highest risk of importing products that don't meet the FDA's standards and violate U.S. laws," said Michael Chappell, acting Associate Commissioner for Regulatory Affairs at FDA. "Consumers should know that only companies that maintain control over their products will be selected into this pilot program."

Companies wishing to participate in the two year pilot program must meet certain criteria, including:

* For finished drug products, the applicant must hold an FDA-approved drug application or must be the foreign manufacturer identified in an FDA-approved application;
* The active pharmaceutical ingredients imported must be used only to make FDA‑approved drugs;
* Foreign drug manufacturers and U.S. establishments receiving drugs must be FDA-registered and comply with Good Manufacturing Practices; and
* Applicants must show that their drug products use a secure supply chain.

The pilot program is planned to run for a period of two years.

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Preterm Births Rise 36 Percent Since Early 1980s

/PRNewswire-USNewswire/ -- New government statistics confirm that the decades-long rise in the United States preterm birth rate continues, putting more infants than ever at increased risk of death and disability according to the March of Dimes.

Nearly 543,000 babies were born too soon in 2006, according to the National Center for Health Statistics, which today released "Births: Final data for 2006," National Vital Statistics Reports; Vol. 57, No. 7. The nation's preterm birth rate (birth before 37 completed weeks gestation) rose to 12.8 percent in 2006 -- that's a 36 percent increase since the early 1980s.

The report attributed much of the increase to the growing number of late preterm infants (those born at 34 to 36 weeks gestation), which increased 25 percent since 1990. The report also noted an increase in preterm births to Hispanic women, while rates were unchanged for non-Hispanic whites and blacks. However, black women continue to have the highest preterm birth rate, at 18.5 percent.

The preterm birth rate continued to rise despite the fact that multiple births, a known risk factor for preterm birth, have begun to stabilize. The rate of twin births was unchanged in 2005 and 2006, and triplets and higher order multiples declined 5 percent in 2006.

"The health consequences for babies who survive an early birth can be devastating and we know that preterm birth exacts a toll on the entire family -- emotionally and financially," said Dr. Jennifer L. Howse, president of the March of Dimes.

"We've are committed to raising public awareness about premature birth, and we believe there are concrete steps we can take to solve this problem, including ensuring that all women of childbearing age have access to health insurance and expanding our nation's investment in research into the causes and strategies to prevent preterm birth" Dr. Howse continued.

Preterm birth is the leading cause of death in the first month of life and a contributing cause in more than a third of all infant deaths. Babies who survive an early birth face the risk of serious lifelong health problems and even late preterm infants have a greater risk of breathing problems, feeding difficulties, temperature instability (hypothermia), jaundice, delayed brain development and an increased risk of cerebral palsy and mental retardation.

Last month, the March of Dimes issued its first-ever Premature Birth Report Card, which gave the United States a "D" -- and not a single "A" to any state -- by comparing 2005 preterm birth rates to the national Healthy People 2010 objective of 7.6 percent. The report card is online at www.marchofdimes.com/petition.

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Cleveland Clinic Surgeons Perform Nation's First Near-Total Face Transplant

/PRNewswire/ -- A multi-disciplinary team of doctors and surgeons at Cleveland Clinic recently performed the first near-total face transplant in the United States.

In a 22-hour procedure performed within the past two weeks, surgeons transplanted 80 percent of a woman's face who suffered severe facial trauma -- essentially replacing her entire face, except for her upper eyelids, forehead, lower lip and chin. For the privacy and protection of those involved, no information will be released on the patient, the donor or their families. (A written statement from the patient's sibling is available at http://www.clevelandclinic.org/face.)

This is the largest and most complex face transplant in the world, integrating different functional components such as nose and lower eyelids, as well as different tissue types including, skin, muscles, bony structures, arteries, veins and nerves.

"This work demonstrates the Cleveland Clinic's commitment to improving the lives of patients through innovation," said Delos M. "Toby" Cosgrove, M.D., President and CEO, Cleveland Clinic. "By advancing scientific research in microsurgery and transplantation, Cleveland Clinic is setting new standards of care. I'm extremely proud of the team who worked tirelessly to make a difference in this patient's life."

The transplant team was led by Maria Siemionow, M.D., Ph.D., Director of Plastic Surgery Research and Head of Microsurgery Training, who received worldwide attention in November 2004 when the Clinic's Institutional Review Board (IRB) announced that face transplantation is both ethical and possible by approving the first protocol for the surgery. Siemionow, a highly regarded scientist, has dedicated her professional life to researching and developing the methods doctors could use to substantially help patients with severe facial disfiguration.

"As a physician, one of the most rewarding things we can do is to restore the quality of life to a patient," said Siemionow (pronounced "SEMM-ih-nof"). "Patients with facial disfigurement have very difficult challenges in society. We hope that one day we may be able to help the tens of thousands of patients who are quietly suffering."

Frank A. Papay, M.D., Chairman of the Dermatology and Plastic Surgery Institute, said the surgery was made possible because of the multi-disciplinary team involved. "This work started with a medical team that had an extraordinary vision for what could be possible for patients who have suffered severe trauma to their faces. Cleveland Clinic's team has worked together to take that vision and make it a reality," Papay said. "In the end, we're all here for our patients to make their lives better."

Cleveland Clinic Dermatology and Plastic Surgery Institute led the face transplant surgery, partnering with the Cleveland Clinic Head & Neck Institute. Staff members from psychology/psychiatry, bioethics, social work, anesthesia, transplant, nursing, infectious disease, dentistry, ophthalmology, pharmacy, environmental services and security were also significantly involved.

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New Cases of Diagnosed Diabetes on the Rise

The rate of new cases of diagnosed diabetes rose by more than 90 percent among adults over the last 10 years, according to a study by the Centers for Disease Control and Prevention (CDC).

The data, published in CDC′s Morbidity and Mortality Weekly Report, show that in the past decade, the incidence (new cases) of diagnosed diabetes has increased from 4.8 per 1,000 people during 1995-1997 to 9.1 per 1,000 in 2005-2007 in 33 states.

“This dramatic increase in the number of people with diabetes highlights the increasing burden of diabetes across the country,” says lead author Karen Kirtland, Ph.D., a data analyst with CDC′s Division of Diabetes Translation. “This study demonstrates that we must continue to promote effective diabetes prevention efforts that include lifestyle interventions for people at risk for diabetes. Changes such as weight loss combined with moderate physical activity are important steps that individuals can take to reduce their risk for developing diabetes.”

The study used data from CDC′s Behavioral Risk Factor Surveillance System, and provides incidence rates of diabetes for 43 states and two U.S. territories. Only 33 states had data for both time periods, but 43 states collected data in 2005-2007.

State-specific, age-adjusted estimates of new cases of diabetes ranged from 5 per 1,000 people in Minnesota to 12.7 per 1,000 in West Virginia. The number of news cases was highest in Puerto Rico at 12.8 per 1,000. States with the highest age-adjusted incidence were predominately Southern states: Alabama, Florida, Georgia, Kentucky, Louisiana, South Carolina, Tennessee, Texas and West Virginia.

“This report documents the geographic distribution of new cases of diabetes and is consistent with previous studies showing an increase in new diabetes cases,” said Kirkland. “We must step up efforts to prevent and control diabetes, particularly in the Southern U.S. region where we see higher rates of diabetes, obesity and physical inactivity.”

CDC, through its Division of Diabetes Translation, funds diabetes prevention and control programs in all 50 states, including the District of Columbia, and seven U.S. territories and island jurisdictions. The National Diabetes Education Program, co-sponsored by CDC and the National Institutes of Health, provides diabetes education to improve treatment for people with diabetes, promote early diagnosis and prevent or delay the onset of diabetes.

For more information about diabetes, visit www.cdc.gov/diabetes. The MMWR report is available at www.cdc.gov/mmwr.

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CDC Releases New Infant Mortality Data

The United States ranked 29th in the world in infant mortality in 2004, compared to 27th in 2000, 23rd in 1990 and 12th in 1960, according to a new report from CDC's National Center for Health Statistics (http://www.cdc.gov/nchs).

The U.S. infant mortality rate was 6.78 infant deaths per 1,000 live births in 2004, the latest year that data are available for all countries. Infant mortality rates were generally lowest (below 3.5 per 1,000) in selected Scandinavian (Sweden, Norway, Finland) and East Asian (Japan, Hong Kong, Singapore) countries. Twenty-two countries had infant mortality rates below 5.0 in 2004.

The findings are published in a new Data Brief "Recent Trends in Infant Mortality in the United States." The data come from the Linked Birth/Infant Death Data Set and Preliminary Mortality Data File, collected through the National Vital Statistics System.

The report shows the U.S. infant mortality rate did not decline from 2000 to 2005. However, preliminary data for 2006 show a significant 2 percent decline between 2005 and 2006. Other findings include:

-- The current U.S. infant mortality rate is about 50 percent higher than
the national goal of 4.5 infant deaths per 1,000 births.
-- The infant mortality rate for non-Hispanic black women was 2.4 times
the rate for non-Hispanic white women. In 2005, the infant mortality
rate for non-Hispanic black women was 13.63 infant deaths per 1,000
live births, compared to a rate of 5.76 for non-Hispanic white women.
Rates were also higher for Puerto Rican and American Indian women,
8.30 and 8.06 respectively.
-- Increases in preterm birth and preterm-related infant mortality
account for much of the lack of decline in the United States' infant
mortality rate from 2000 to 2005.

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