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February 2002
expert urges better checks on winter vomiting [top] [next]
A better reporting system for cases of winter vomiting – the viral infection which has recently forced hospitals to cancel operations and admissions – could help infection specialists prevent and control future outbreaks, according to a Glasgow specialist writing in the British Medical Journal.
The Norwalk-like virus responsible for the recent outbreak is thought to cause at least as many cases of diarrhoea and vomiting in the UK as better known microbes, such as salmonella (see how to keep food poisoning in retreat). But cases generally go unreported.
'Surveillance of cases and outbreaks in the United Kingdom massively underestimates the size of the problem of infections with Norwalk-like viruses,' explains Dr John Cowden from the Scottish Centre for Infection and Environmental Health, Glasgow. 'It is obviously inappropriate to ask general practitioners to send faecal samples from every mild case of diarrhoea that presents to them, but a sentinel system would improve our knowledge of infection with these viruses in the population,' he adds.
Dr Cowden points out that it takes as few as 10 Norwalk-like viruses to trigger 24-48 hours of nausea, vomiting, diarrhoea and stomach cramps, though symptoms can last a week or more. The virus is spread in food and water, so anyone with diarrhoea should not prepare food for other people until 48 hours after symptoms have disappeared. The projectile nature of the vomiting also helps spread the infection.
There is no specific treatment, other than to drink plenty of liquids to prevent dehydration, and there are no long term effects.
The Norwalk-like virus gets its name from the Ohio town where it was first identified in 1972. The commonest sub-types in the UK are named Southampton, Taunton, Bristol and Lordsdale, after the places where they were isolated.
help and info
'Winter Vomiting' by J Cowden, in British Medical Journal, vol 323 (2 February 2002), pages 249-250. The full text is available at www.bmj.com
Winter Vomiting Virus
http://news.bbc.co.uk/hi/english/health/medical_notes/t-z/newsid_1776000/1776368.stm
This BBC News article describes the effect the virus has, and how easily it is spread.
Outbreaks of Winter Vomiting Disease
www.phls.co.uk/news/bulletins/2002/020124id.htm#1
News bulletin from the Public Health Laboratory Service (PHLS), describing the disease, symptoms, treatments, and the PHLS view of the current outbreaks.
big drop in heart disease deaths [top] [next]
The annual number of deaths from heart disease has dropped by 13,000 in just two years but, at 2.6 million, the number of people living with the disease has stayed the same.
Figures released by the British Heart Foundation (BHF) suggest that improvements in the diagnosis and treatment of heart disease are helping to cut heart deaths, but failure to lead a healthier lifestyle means that as many people as ever are suffering symptoms. Those living in Scotland and the north of England continue to be worse affected than those in the south.
The BHF estimates that over a third of all heart disease is now due to lack of physical activity and wants the government to set targets for getting Britain's sedentary population off its sofas.
'Medical research can do so much to save lives, but in the long run people must take responsibility for their actions. If the sedentary population were to do 30 minutes of physical activity five times a week, heart disease deaths would be reduced by around 10%,' said Professor Sir Charles George, medical director of the BHF.
- New government statistics also confirm that deaths from heart disease are falling, as are those from cancer. Men can now expect to live until they are 75 and women until they are 80, according to latest figures from the Department of Health.
help and info
British Heart Foundation
14 Fitzhardinge Street
London W1H 6DH
Tel: 020 7935 0185 (Mondays to Fridays 9am-5pm)
Healthy Heart Information Request Line: 0870 600 6566 (recorded information line)
Website: www.bhf.org.uk
Plays a leading role in the fight against heart disease and provides a range of information about the causes, prevention and treatment of the problem. The recorded information line can be contacted to request information on a range of topics. The website contains a glossary, details of publications, and practical advice on how to protect yourself from heart disease.
Better Cancer Survival and More Heart Surgery
www.doh.gov.uk/newsdesk/latest/4-naa-01022002.html
Department of Health news release stating that more patients are surviving cancer and getting the heart operations they need, with a link to the full figures.
cancer patients advised what questions to ask [top] [next]
A new booklet, Questions for Patients to Ask, is advising cancer patients to ask their doctors, surgeons and nurses whether they are suitablytrained to treat them. The booklet is produced jointly by the Commission for Health Improvement and the Audit Commission, which recently reported unacceptable variations in the quality of care offered to cancer patients around the country (see the January 2002 news item cancer care could do better).
The new booklet, available for download or from the cancer support charity, CancerBACUP, contains 50 questions which patients may want to ask at various stages in the diagnosis and treatment of their illness. Alongside each question is the sort of response they should ideally expect.
'The questions and hallmarks in this booklet give a clear indication of what good care should look like and will help patients communicate with all the different health professionals they see throughout their illness,' said Sir Andrew Foster, controller of the Audit Commission.
help and info
Questions for Patients to Ask (Commission for Health Improvement and Audit Commission, 2002)
Can be downloaded from the Commission for Health Improvement website at www.chi.nhs.uk/cancer/questions.shtml and the Audit Commission website at www.audit-commission.gov.uk. The booklet is also available from CancerBacup (see below).
CancerBacup
Cancer Information Service: 0808 800 1234 (Mondays to Fridays 9am-7pm)
Website: www.cancerbacup.org.uk
Call the information service for a copy of Questions for Patients to Ask. Specialist cancer nurses provide information on all aspects of cancer and its treatment, and on the practical and emotional problems of living with the illness. The website contains a range of information leaflets.
can cooling newborn babies prevent disability? [top] [next]
Babies who cannot get enough oxygen at birth are to have their temperature reduced by a few degrees as part of a major new Medical Research Council trial. The aim is to prevent the serious brain injuries which may arise in up to 1 in 500 babies who are asphyxiated at birth.
Asphyxia occurs if a baby's supply of blood and oxygen is obstructed during birth. A quarter of all babies suffering moderate asphyxia at birth develop cerebral palsy and, at present, there is no treatment to prevent the serious physical and mental disabilities that can arise.
Experimental and small-scale studies have suggested that lowering body temperature may reduce the adverse effects of asphyxia. In the new trial, half of the babies who take part will have their temperature kept normal while half will be cooled to 3-4 degrees Celsius below normal for three days. The cooling will be carried out by nursing the baby on a water filled mattress. All the children in the trial will be followed up for 18 months to find out whether the cooling treatment has long term benefits.
'If the trial shows that this is an effective treatment for asphyxia, we'll be recommending that baby-cooling should be adopted into clinical practice in the NHS. If it's shown not to be effective, indiscriminate use of the technique will be discouraged,' said Dr Denis Azzopardi, senior lecturer at Imperial College, London.
help and info
Medical Research Council
www.mrc.ac.uk
Aims to improve health by promoting research into all areas of medical and related science. The website includes a press release describing the baby cooling research.
SCOPE
Cerebral Palsy Helpline: 0808 800 3333 (Mondays to Fridays 9am-9pm and Weekends 2-6pm)
Website: www.scope.org.uk/information
Runs a wide range of services for people with cerebral palsy, and their families and carers, throughout England and Wales. The free and confidential helpline provides information, support and advice. Leaflets can be sent out to parents on therapies and other aspects of living with a disability, and can also be found on the website.
BLISS
The National Charity for the Newborn
68 South Lambeth Road
London SW8 1RL
Tel: 0870 7700 337 (Mondays to Fridays 9am-5.30pm)
Bliss National Telephone Support Network: 0500 618 140 (Mondays to Fridays 10am-5pm, answerphone out of hours)
E-mail: information@bliss.org.uk
Website: www.bliss.org.uk
Aims to provide life saving equipment so all Special Care Baby Units around the UK can provide the best possible care for sick newborn babies. Provides advice, support and information for families and health professionals. The Bliss National Telephone Support Network is for parents, by parents, and offers short-term support and further information.
internet sweep for false health claims [top]
A recent internet sweep has targeted hundreds of websites offering miracle cures and other dubious health advice. Transgressors are being warned that they must abide by the same advertising standards and consumer protection regulations as companies operating on a terrestrial level.
The UK's Office of Fair Trading is one of dozens of organisations that takes part in regular web sweeps coordinated by the International Marketing Supervision Network. As part of last month's sweep, led by the Australian Competition and Consumer Commission (ACCC), consumers were advised to watch out for 'cure-alls' for multiple ailments or undiagnosed pain, and to be cautious about testimonials claiming amazing results. 'Scientific breakthroughs' and 'exclusive ingredients' should also be viewed with suspicion, said the ACCC.
'Many people turn to the Internet because it provides consumers with easy access to information about their health concerns. However, it is important for consumers to be aware that the internet also provides promoters of fraudulent health products and treatments easy access to consumers from all over the world,' said ACC chairman, Professor Allan Fels.
help and info
Advertising Standards Authority
www.asa.org.uk
Independent, self-regulatory body for non-broadcast advertisements in the UK. Administers the British Codes of Advertising and Sales Promotion to ensure that ads are legal, decent, honest and truthful.
Consumer Affairs Directorate
www.dti.gov.uk/CACP/ca/work9.htm
Features information on distance selling, and e-commerce and the law, with a range of resources and links.
International Marketing Supervision Network
www.imsnricc.org
A network of governmental organisations involved in the enforcement of fair trade practice laws and other consumer protection activities. Features information about International Internet Sweep Days, and links to www.econsumer.gov, a website for cross-site e-commerce complaints.
Office of Fair Trading
www.oft.gov.uk
Plays a leading role in promoting and protecting consumer interests throughout the UK, while ensuring that businesses are fair and competitive. The website has information on consumer rights, including online shopping advice and information on spotting scams and health/beauty 'miracle' products.
ME is a real disease – official! [top] [next]
Doctors have been urged to recognise and, where possible, treat chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME), in a new report from an Independent Working Group to the Chief Medical Officer.
The report points out that an early, positive diagnosis can improve the prognosis for people with CFS/ME and recommends appropriate clinical evaluation and follow up, with most care coordinated by GPs. Graded exercise/activity programmes, cognitive behaviour therapy and pacing are among the therapies considered worthwhile.
'We have achieved agreement on many aspects of care for people with CFS/ME, even though some differences of opinion remain over the best ways of managing the illness,' concluded Professor Allen Hutchinson, chairman of the CFS/ME Independent Working Group.
CFS/ME is a debilitating illness which affects an estimated 150,000 people in the UK. Fatigue, brought on by physical activity, is accompanied by problems with memory, concentration and feeling of having flu all the time. Other symptoms include muscle pain, problems with balance and disturbances in temperature control. The cause of CFS/ME is unknown, but many cases are triggered by infection. Because of the long term nature of the illness and the difficulty in finding a specific cause, many people with CFS/ME have found it hard to get help for the condition or even to convince people that they are ill.
ME Association (MEA) chief executive, Val Hockey, welcomed the main findings of the report:
'This really is a wake-up call for the entire medical profession. It is no longer acceptable for doctors to claim that "CFS/ME is an illness that does not exist" or that "nothing can be done" to help these people... The MEA is taking the view that the report marks the beginning of a process, it is not an end in itself.'
help and info
ME Association
4 Top Angel
Buckingham Industrial Park
Buckingham MK18 1TH
Listening Ear Helpline: 01375 361013 (7 days a week)
Fax: 01280 821602
E-mail: enquiries@meassociation.org.uk
Website: www.meassociation.org.uk
Aims to support and empower anyone affected by ME. Services include information provision via the website or an information pack (on receipt of an SAE). The Listening Ear is the helpline for the ME Association, available to members and non-members. It does not give medical advice, but can give information and support on the condition, its symptoms and the loss of career and friends due to the illness.
Action for ME
PO Box 1302
Wells
Somerset BA5 1YE
Helpline: 01749 670799 (Mondays to Fridays 10am-4pm)
E-mail: admin@afme.org.uk
Website: www.afme.org.uk
Aims to raise awareness about ME, and campaigns for better care for people with ME. Provides information, self-help and support services to people with ME, their carers, family and friends. The helpline gives information about ME and details of membership. Members of Action for ME have access to helplines for counselling and benefits enquiries and receive a quarterly magazine.
Association of Young People with ME (AYME)
PO Box 605
Milton Keynes MK2 2XD
Tel: 01908 373300
E-mail: info@ayme.org.uk
Website: www.ayme.org.uk
National patient support organisation for children and young adults with ME. The website gives information on education-related issues, with details of useful resources and links.
Patient Information Publications
www.patient.org.uk
A directory of UK health, disease and related websites. It is edited by two GPs and contains useful links and publications for all major disease and health issues.
Support ME
www.supportme.co.uk
An on-line resource for sufferers of ME. Aims to provide information on new research from around the world, including helpful information, message boards and support.
A Report of the CFS/ME Working Group is available from the Department of Health
www.doh.gov.uk/cmo/cfsmereport
arthritis drug may prevent miscarriage [top] [next]
A new type of anti-arthritis drug may help women with fertility problems to have a baby. The drug, called etanercept (Enbrel) blocks the action of a natural chemical in the body, called tumour necrosis factor (TNFalpha), which triggers inflammation in arthritic joints. It is already used to treat rheumatoid arthritis
TNFalpha is produced by natural killer cells of the immune system which are also thought to play an important role in destroying embryos in some women who have recurrent miscarriages.
Speaking at the recent British Fertility Society meeting in Nottingham, Professor Alan Beer, from Chicago Medical School, reported a study in which three quarters of women who took Enbrel before fertility treatment became pregnant. All had previously had three or more failed attempts at in vitro fertilisation (IVF). Similar results were achieved with women who had repeated miscarriages.
Research suggests that some women who have recurrent miscarriages after a first successful pregnancy produce excess numbers of natural killer cells in subsequent pregnancies which prevent embryos from implanting or cause miscarriages in other ways.
help and info
Reproductive Medicine Programme
www.repro-med.net
The Chicago Medical School's website which gives details of research aimed at helping couples become pregnant and prevent miscarriages.
back seat belts prove their worth [top] [next]
Failing to wear a seat belt in the back seat of a car dramatically increases your risk of killing someone in the front seat if you have an accident. Results of a study of nearly 400 front seat drivers and passengers who were killed on Japanese roads showed that the risk of death was five times higher when back seat passengers did not wear seat belts.
The danger was especially great in head-on collisions when unbelted back seat passengers were likely to have been thrown forward, hitting those in the front seats with substantial force.
help and info
'Mortality of Front-Seat Occupants Attributable to Unbelted Rear-Seat Passengers in Car Crashes' by M Ichikawa and others in The Lancet, vol 359 (5 January 2002), pages 43-44 www.lancet.com
thousands die due to lack of aspirin [top] [next]
Around 3,000 more lives could be saved each year if everyone with heart disease and other circulatory problems who would benefit from aspirin actually took it.
Latest research from the British Heart Foundation and Medical Research Council (MRC) shows that, in high risk groups, aspirin reduces heart attacks and strokes by about 25%. But recent surveys show that less than half of people who would benefit from aspirin are prescribed it by their doctor. Those with arterial disease in their legs appear to be missing out most.
'Aspirin is currently prescribed to less than a quarter of people with diseases such as peripheral arterial disease – a condition which causes fatty deposits to build up in the leg's arteries and in which heart attacks and strokes are common,' explains Dr Colin Baigent, the MRC scientist who led the research.
'We believe that aspirin may well have helped to protect these high risk patients but sadly many will die from their very first heart attack – by which time aspirin is too late,' he adds.
He and other researchers stress that anyone who thinks they may be at high risk of a heart attack or stroke because they have heart disease, angina, diabetes or peripheral artery disease should consult their doctor before taking aspirin regularly.
help and info
British Heart Foundation
14 Fitzhardinge Street
London W1H 6DH
Tel: 020 7935 0185 (Mondays to Fridays 9am-5pm)
Website: www.bhf.org.uk
Plays a leading role in the fight against heart disease and provides a range of information about the causes, prevention and treatment of the problem. Website contains a glossary, details of publications, plus practical advice on how to protect yourself from heart disease.
Medical Research Council
www.mrc.ac.uk
The national organisation for research in all areas of medical and related science, aiming to improve the health and quality of lifeof the people of the UK.
Stroke Association
Stroke House
123 Whitecross Street
London EC1Y 8JJ
Stroke Information Service Helpline: 0845 3033 100 (Mondays to Fridays 9am-5pm)
E-mail: info@stroke.org.uk
Website: www.stroke.org.uk
Provides information and support for people affected by stroke, and funds research into stroke prevention, diagnosis, treatment, rehabilitation and care. Also produces a wide range of publications.
'Collaborative Meta-Analysis of the Randomised Trials of Antiplatelet Therapy for Prevention of Death, Myocardial Infarction, and Stroke Among High Risk Patients' by Antithrombotic Triallists' Collaboration in BMJ, vol 324 (11 January 2002), pages 71-86 www.bmj.com
meningitis jabs extended to all under-25s [top] [next]
The vaccine against meningitis C infection which used to be responsible for 40% of cases of the potentially fatal illness in schoolchildren is to be offered to all under-25s. The vaccine, which was introduced in 1999, is now part of the routine UK childhood immunisation programme. But, until recently, the campaign was focused on under-18s.
However, as meningitis infection is twice as common in people aged 20-24 as in the rest of the adult population, immunisation against meningitis C is being extended to all adults under the age of 25.
help and info
The Meningitis Trust
Fern House
Bath Road
Stroud
Gloucestershire GL5 3TJ
Tel: 0845 6000 800 (local call rate, 24 hours)
E-mail: info@meningitis-trust.org.uk
Website: www.meningitis-trust.org.uk
Supports people with meningitis, and their families. There is a 24-hour emergency helpline for anyone who is concerned, anxious, or distressed about meningitis and meningococcal disease. The website has information on the vaccine and the new age policy. There is also information on counselling services and financial aid.
Go to our get help directory for details of other organisations, websites and further reading.
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