"Superbugs" on the rise.Streptococcus pneumoniae, the cause of acute otitis media and other serious respiratory infections, is becoming drug resistant. Nine children in New York were sickened with a strain resistant to all 18 antibiotics approved for use in children, according to a report in the October 17, 2007, issue of JAMA. And methicillin-resistant Staphylococcus aureus (MRSA) infections are growing more common, according to Centers for Disease Control and Prevention (CDC) experts in the same issue of JAMA. Most invasive MRSA infections occurred in people with known risk factors or originated in the health care system; fewer than 14% of the cases of invasive MRSA occurred in people with no risk factors. Cases of MRSA skin infection in schools nationwide created a flurry of reactions, including school closings and "sterilizations," and health officials sought to quell fears among parents and teachers over MRSA transmission.
In November, the CDC reported the possible emergence of a more virulent strain of adenovirus type 14 in New York, Washington, Oregon, and Lackland Air Force Base in Texas. Of the 141 confirmed cases, nine (5%) died; 53 (38%) required hospitalization, with 24 requiring critical care.
Changes in ovarian and breast cancer screening. For the first time, experts recognized a constellation of symptoms that could indicate the presence of early ovarian cancer and should prompt women and their health care providers to test further for ovarian cancer (see In the News, September 2007). And the American Cancer Society and the Canadian Cancer Society no longer recommend breast self-examination as a method of screening for breast cancer because it might offer false security to women who are not performing it properly. Women should still examine their breasts so that they are familiar with how they normally feel, but mammograms and breast examination by a trained clinician are recommended.
The overall annual rate of U.S. cancer deaths dropped 2.1% between 2002 and 2004, nearly double the annual decline between 1993 and 2002, according to a report by U.S. cancer agencies in the October 15, 2007, online issue of Cancer. Breast cancer cases in women fell 3.4%, the first decline in 20 years, and ovarian cancer fell 3.3%. The incidence of colorectal cancer decreased by more than 2% in men and women.
Illnesses that are prevented with vaccines are at the lowest levels ever, according to the CDC, demonstrating the effectiveness of immunization. The number of cases of diphtheria, measles, polio, rubella and congenital rubella syndrome, and smallpox all showed declines of more than 99% since vaccination programs were implemented.
The lowest numbers ever of illegal tobacco sales across the United States were reported by the Substance Abuse and Mental Health Services Administration. The gains are attributed to the Synar Amendment program, a federal and state initiative that aims to reduce tobacco sales to minors. All states and the District of Columbia reported 80% compliance among tobacco retailers, a sharp contrast to the 25% compliance rate 10 years ago when the program began.
The prevalence of type 2 diabetes rose 33% in children over the past 15 years, mirroring the rise in obesity. The American Diabetes Association now recommends screening high-risk youths for type 2 diabetes every two years with a blood glucose test, according to the September 1, 2007, issue of American Family Physician.
A Phase 2 trial of an HIV vaccine was stopped early after the number of volunteers who developed HIV infection after receiving the vaccine was found to be higher than the number who developed HIV after receiving the placebo. The Merck vaccine failed to prevent infection or reduce levels of HIV in people who became infected and appears to have increased susceptibility in certain individuals.
Falling short: the United Nations' Millennium Development Goals. Unless something changes, they won't be met in 2015, the target year. The reduction of the number of people living in extreme poverty is half of what it needs to be; the decrease in under-five child mortality is negligible, from 185 per 1,000 live births to 166 per 1,000 live births; and maternal mortality in sub-Saharan Africa continues to be disgraceful; one out of 16 women die in childbirth, compared with one in 3,800 in the developing world.
Carol Potera
Maureen Shawn Kennedy, MA, RN, News Director
Karen Roush, MSN, RN, FNP, Editorial Director