4B
LIFE/Clbe C|iar(otte
Thursday, August 10, 2006
Cough, sniffle... the flu vaccine
Continued from page 1B
nasal spray and the injection
(shot) have been shown to
prevent the flu effectively.
Another myth is , “Since I
was vaccinated last year, I
don’t have to be vaccinated
again.” This statement is also
false. The influenza viruses
change {mutate) their outer
coating frequently. They can
thereby evade our human
defenses, requiring that we
be vaccinated each year to
have protection against the
current strain.
Who gets vaccine?
The flu vaccine is recom
mended for people over 6
months of age, both healthy
and with chronic medical con
ditions. It is strongly recom
mended for those who have a
chronic medical condition;
thos.e over 65 years of age,
(especially if they live in a
nursing home or other area
that houses people with
chronic medical conditions);
those with heart conditions or
conditions that can compro
mise respiratory function,
such as a brain injury, asth
ma, or a seizure disorder;
children (especially those
aged 6 to 23 months of age);
women who are pregnant;
those with a weakened
immune system (including
those with HIV/AIDS); and
caregivers and healthcare
providers, or those who are at
risk for transmitting the
virus to others.
People should NOT take it
ffthey are severely allergic to
chicken eggs; they have had a
severe reaction to the flu vac
cine in the past, including
Guillain-Barre Syndrome;
they are under 6 months of
age; or they have an illness
with a fever (wait until the
symptoms subside).
Like any medication, the flu
vaccine can cause side effects.
The most common are mild
symptoms that may develop
soon after the vaccine is given
and generally last for 1-2
days. This may include red
ness or swelling near site of
injection, low-grade fever
and/or muscle aches. Severe,
life-threatening allergic reac-
Doctors hunting for a way
to protect tiniest babies
By Lauran Neergaard
THE ASSOCIATED PRESS
WASHINGTON - It’s one of the grimmest
threats to premature babies: Their immature
intestines break down. They can’t be fed. In the
worst cases, holes in the bowel let bacteria leak
into the blood - and lull.
This mysterious disorder is expected to soon
overtake lung disease as the leading killer of
preterm infants, and researchers are strug
gling to figure out why it strikes and develop
the first real protection.
“We’re keeping the most fragile and vulnera
ble babies alive longer” with better respiratory
care, but “at a price,” laments Dr. David
Hackam of Children’s Hospital of Pittsbiugh.
‘What hasn’t gotten out is that many of these
babies then are at risk of developing NEC” —
the shorthand term for necrotizing enterocoli
tis, a severe intestinal inflammation that can
bhndside doctors and parents alike.
Diana Seabol’s experience is typical: Her
twins were bom almost 21/2 months early.
’Three weeks later, she was ecstatic that son
Cameron’s lungs were strong enough to come
off a ventilator _ only to watch him be rushed
to Hackam’s hospital for emergency surgery
that same day because his intestines had per
forated.
“Nobody really talked to me about what hap
pens with preemies,” said Seabol, whose son,
now 2, survived that first bout with NEC and
some life-threatening complications a few
months later. '-It would have been nice to look
for some signs.”
NEC occasionally hits a fidl-term infant, but
mostly afflicts the tiniest preemies, bora small
er than 31/2 pounds. Estimates vary, but
Hackam said NEC may affect as many as one
in five preterm infants.
The National Center for Health Statistics
reports there -were about 500,000 pre-term
babies bom in 2004, the most recent data
available.
It starts with subtle symptoms, such as poor
food tolerance. In babies diagnosed early, feed
ing is stopped to let the intestines rest and
hopefiflly heal themselves. They’re also given
intravenous antibiotics. About half recover.
But the rest worsen, their abdomens swelling
as inflammation increases. Bacteria inside the
intestines leak out, causing bloodstream infec
tions. Surgery is required to remove portions of
dead intestine, but “by the time you get to that
stage, it is too late,” says Dr. Gail Besner of
Columbus Children’s Hospital. “The damage
has already been done.”
About half of babies with severe NEC die,
and survivors can face lifelong complications
depending on how much of their bowel was
lost.
The goal: Tb develop drags that can protect
these ^gile babies’ intestines from becoming
Urban planners create
new conununities
Continued from page 3B
houses, detaching the garages and shrinking
the lawns down to the size of postage stamps.
For this reason, the movement sometimes
goes by the moniker “neotraditionalism.” 'That
means the features New Urbanists lovingly
include in their designs are also available in
many older towns and cities across the country.
Take, for instance, a city neighborhood such
as Uptown, in Minneapolis, or small towns like
Your weekly source for
community news and
infomration
tions reactions are extremely
rare.
Overall, the potential bene
fits far outweigh the risks.,
November ushers in flu sea
son, and now is time to get
your flu vaccine by visiting
your doctor or the local health
department.
Remember, knowledge is
power, but it is what you do
with it that makes all the dif
ference!
Contributed by Ramon Velez,
MD., professor of medicine, Wake
Forest University School of
Medicine; Primary Care and
Preventive Medicine Service Line
Coordinator, VISN 6.
For more information about the
Maya Angelou Research Center
on Minority Health, visit our web
site at www.wJubmc.edu/minoriry-
health. Or,for health information,
call 336.713.7578.
inflamed in the first place, just as doctors now
routinely give preemies lung-protecting thera
pies.
Besner discovered a growth factor, named
HB-EGF, that promises to do that.
The body normally produces this protein,
which helps stimulate intestinal cells to grow
and counters inflammation. It’s found in the
amniotic fluid that nurtures a fetus, and in
breast nulk. (In fact, prematiue infants given
breast milk through their feeding tubes seem
to have a lower risk of NEC than those who
receive formula.)
Giving extra doses of the'grovifth factor to
newborn rats whose intestines were dehber-
ately stressed greatly reduced their chances of
getting NEC, and helped those who stfll got it
to siuwive, Besner found. Now she is seeking
permission from the Food and Drag
Administration to begin the first human stud
ies, by administering doses straight into high-
risk preemies’ feeding tubes.
In Pittsburgh, Hackam found a different mol
ecule that seems important for intestinal heal
ing.
The “intestinal barrier,” or lining, Hackam
describes as “a real living fort,” requiring con
stant maintenance to seal off injuries before
bacteria can penetrate them. Cells called ente-
rocytes are the repair workers, swarming over
to patch any breach.
But the intestinal barrier in newborns, espe
cially premature infants, isn’t fuUy developed
and thus has an impaired ability to do those
repairs, Hackam discovered.
Moreover, in babies ivith NEC, a switch that
acts like a brake is turned on inside their
intestinal cells, abruptly halting the entero-
cytes’ movement. He’s now hunting drags to
turn that switch back off, so the babies’ innqte
ability to heal can finish developing, and he
hopes to begin clinical trials within a few years.
For now, hospitals are supposed to watch
closely for the earliest signs of NEC; it’s one
reason that feeding is begun slowly for small
preemies.
But parents have a big role, too, Pittsburgh’s
Seabol points out. They may be first to notice
warning signs, even after survivors go home.
At 4 months, Cameron suddenly quit finishing
his bottles, and his mother had to insist to ini
tially skeptical doctors that something was
very wrong. Indeed, a temporary patch firom
his initial surgery had quit working, leaving
the baby imable to absorb food. After a month
in the hospital,. Hackam successfully reat
tached the remaining ends of Cameron’s
intestines.
Now 2, Cameron is thriving, “but I’m aware
it could come back at any time,” Seabol says.
Lauran Neergaard covers health and medical issues
for The Associated Press in Wa.shington.
Portland, Maine, Flagstaff, Ariz,, or Madison,
Wis. All have sidewalks, public transport and
discernible centers - central characteristics of
New Urbanism.
“If it’s walkable and compact and diverse and
so forth,” said Duany. "Insofar as it is that,
then it’s New Urbanist.”
On the Web: http://www.smithsonian-
magazine.com
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