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A case of the infectious blood disease meningococcemia has been recorded at UNCG, its student newspaper, The Carolinian, reports. We'll have a story for tomorrow, but in the meantime, you can get additional information on the disease from the Guilford County Department of Public Health here.

Area congregational nurses will be giving out 800 flu shots to people in the community who might not get them otherwise. The shots will be distributed through Moses Cone Health System's Congregational Nurse program to at-risk people such as the homeless, immigrants, those on fixed incomes and the working poor, the health system says. They'll be distributed through Greensboro Urban Ministry and 19 local ministries, including FaithStep Ministries, Immanuel Baptist Church, United Montagnard Church, Grace Community Church and The Salvation Army.

For information, call 832-8659.

Alamance County's Department of Public Health now has posted online inspection reports on the facilities it inspects -- restaurants, child-care centers, pools and tattoo parlors among them. To view them, go to http://www.alamance-nc.com, follow the "Health inspections website" link and search by establishment name or from a list of facilities. Reports date back to July.

The National Association of County and City Health Officials and the Centers for Disease Control are sponsoring a Web discussion on how the nation should respond to a pandemic flu outbreak.

From the e-mail:

The chance of a deadly worldwide outbreak of influenza (a pandemic) is increasing, according to experts. Early in such an outbreak, the United States will lack an adequate supply of vaccine. This will be no one's fault. Rather, it will be because developing and making an effective vaccine will take months. The regular flu vaccine we have now probably won't work against any new flu virus powerful enough to cause a pandemic.

If this happens, there will need to be difficult and painful decisions made about how to distribute a limited supply of vaccine. Who should get it first? Who should get it second? What are our priorities?

OK, that's not what it's really called. It's really called National Influenza Vaccination Week, and it runs tomorrow through Dec. 2. Flu sickens millions of Americans each year, and it can be serious. Each year about 36,000 people die of flu or its complications, and about 200,000 are hospitalized with it. So if you haven't gotten a flu vaccination, you probably ought to get one. The Guilford County Department of Public Health has more information here.

The U.S. Consumer Product Safety Commission is urging people to check online for information on recalls of toys possibly contaminated with lead before they buy gifts. A list is available here.

You also can visit the commission's home page to search for recalls dating back to 1973.

I mentioned last week that Moses Cone Health System's Congregational Nursing Program will be distributing free flu shots at some local ministries. Shots will be available from 10 a.m. to 1:30 p.m. tomorrow at Greensboro Urban Ministry, 305 W. Lee St., targeting the working poor and other people who otherwise might not be able to get flu shots. For more information, call 832-8659.

The N.C. Department of Health and Human Services has created a Web site aimed at helping North Carolinians better manage their health. The site is called Eat Smart, Move More N.C. It includes such tools as a calculator of body-mass index, nutritious recipes and other helpful tips. (My body-mass index turns out to be on the high side of normal, and that's only because I've lost a fair bit of weight since the summer.) So check it out.

The N.C. State Center for Health Statistics has just published on its Web site a list of 22 health indicators for the state. Statistics also are available on a county-by-county basis.

The indicators include such categories as various cancer death rates, childhood obesity, and incidence of low birth-weight babies.

The statistics are grouped into three five-year periods for each category to make tracking trends easier.

You can view the statistics at http://www.schs.state.nc.us/SCHS/data/trends/pdf/.

Now that it actually feels like winter, the Guilford County Department of Public Health has posted some winter weather safety tips. Given our propensity in this area for ice-caused blackouts, the list is worth reviewing.

January is Radon Awareness Month. The element, sometimes found in the air in home basements, can cause cancer. The Guilford County Department of Public Health has more information here.

Via the Association of Health Care Journalists listserv, here's a pair of YouTube segments from a new documentary, "The AIDS Chronicles -- Here to Represent," about the effect of AIDS/HIV on the urban African American community in Atlanta. You can read more about it at filmmaker Bailey Barash's Web site.

I published a story today on the investigation, or lack thereof, into the case in which three women developed kidney failure after getting cosmetic injections at a Greensboro establishment. This post at our Debatables blog offers you the chance to discuss the issues the story raises.

And this morning, the state released a settlement agreement with Greensboro's Friendship Care Assisted Living in which the home agreed to close by Jan. 31 and pay a $5,000 fine. The home had a history of violations; the owner's attorney says the state wasn't giving his client a fair hearing. What do you think?

I don't want to let January slip by without noting that January is Radon Action Awareness Month. Why do you care? Because radon is the second-leading cause of lung cancer, causing roughly 21,100 such deaths per year. Many of those who die have never smoked.

Radon comes from the breakdown of uranium in the soil. It can get into the air in your home through cracks in foundations and basements, and through floor drains. Particularly during winter, when doors and windows are closed, it can build to unhealthy levels in homes.

The Guilford County Department of Public Helath says that if you have not previously had your home tested for radon and are interested in testing your home, please call Sandy Ellington at 641-6704. Free radon testing kits will be distributed to interested citizens while supplies last, through the department's Environmental Health Division.

For more information about radon, you can follow this Environmental Protection Agency link.

State researchers have completed the field work on research to determine how widespread exposure is to the chemical toluene diisocyanate and whether those exposed have developed any respiratory problems. The study looked at roughly 400 adults in 10 neighborhoods around four sites where the chemical was used. One of the sites is Olympic Products (formerly Vitafoam) in Pleasant Garden.

(More information about the chemical from the Centers for Disease Control and Prevention is available here.)

Researchers asked residents questions about their respiratory health, took blood samples to check for the presence of the chemical, and took air samples to see what level of the chemical, if any, was present in the air.

They did the same with residents of demographically similar neighborhoods in the state with no known source of exposure to toluene diisocyanate.

Researchers now will review the data and expect to publish their findings in 2009.

Researchers are keeping information about survey participants strictly confidential. But if you took part and would like to talk about it, call me at 373-7088 or shoot me an e-mail. Thanks!

As we reported today, Greensboro ranks No. 10, and Charlotte No. 7, among the worst places to live for asthma sufferers, according to an annual report released by the Asthma and Allergy Foundation of America. The survey was funded by pharmaceutical maker AstraZeneca.

We're planning a local story. If you or a loved one suffers from asthma and you'd like to share your story, please get in touch.

The Guilford County Department of Public Health is working with some area nonprofits to provide free HIV/AIDS testing at several clinics scheduled for this month in Greensboro and High Point. The department's blog post here has more information.

UNCG's Exercise and Sport Psychology laboratory is seeking volunteers for a study.

Candidates need to be between 60 and 90 years old. Subjects would volunteer for one day of activity, including reading or exercise, and cognitive tests.

For more information or to volunteer, e-mail lisabarella@hotmail.com or call 253-5539.

Within the past few days, a record 143 million pounds of beef that had been processed by the Hallmark/Westland Meat Packing Company in Chino, California, was recalled. The recall was prompted by Humane Society video documentation that cattle too sick to stand -- so-called "downer cows" -- were being stood up by workers so that they could be slaughtered and their beef used. U.S. Department of Agriculture policy bans downer cows from the food chain.

One concern about downer cows is that they may be infected with "prion diseases," rare but uniformly fatal brain disorders that can be passed on to humans. The best-known prion disease in humans is Creutzfeldt-Jakob Disease. It has several variations, one of which is believed to be passed to humans from cattle infected with the prion disease BSE (bovine spongiform encephalopathy).

The risk of such infections is not great; the foundation estimates that infection from all sources involves between 250 and 300 U.S. patients per year. But Department of Agriculture regulations are there for a reason, and in the case of Hallmark/Westland, they were being violated on a scale large enough to justify a record-breaking recall.

The Creutzfeldt-Jakob Disease Foundation has more information on this phenomenon. It also has bad news to report regarding inspections for food safety. In a letter to members released Tuesday, the foundation reported that in its opinion, the food-safety net is full of holes:

The CJD Foundation and its members have been vocal advocates for more stringent [U.S. Department of Agriculture] BSE policies and oversight for a long time. Over the past five years we have met with our elected representatives on Capitol Hill to talk about our concerns, and in July 2006 some of us participated in a meeting with the USDA Secretary Mike Johanns and Dr. Richard Raymond, USDA under secretary for food safety. We urged them not to scale back BSE testing from 375,000 to 40,000 (which they proceeded to do one week after our meeting). The statement that the USDA's BSE policy is "not to protect the human food supply but to provide animal surveillance" is chilling. Who then is protecting our food supply and at what point in the process are they doing so?

UPDATE: The Agriculture Department tells Congress that things are just fine:

Agriculture Secretary Ed Schafer told Congress yesterday that he would not endorse an outright ban on "downer" cows entering the food supply or back stiffer penalties for regulatory violations by meat-processing plants in the wake of the largest beef recall in the nation's history.

Appearing at a Senate Appropriations subcommittee hearing, Schafer said the department is investigating why it missed the inhumane treatment of cattle at the Westland/Hallmark Meat Co. in Chino, Calif., including workers administering electric shocks and high-intensity water sprays to downer cows -- those too sick or weak to stand without assistance.

The secretary announced interim steps such as more random inspections of slaughterhouses and more frequent unannounced audits of the nearly two dozen plants that process meat for federal school lunch programs.

But he deflected calls from Sen. Herb Kohl (D-Wis.), the subcommittee chairman, for the government to ban all downer cows from the food supply, increase penalties for violators and require installation of 24-hour surveillance cameras in processing plants.

"The penalties are strong and swift, as we have shown," Schafer said. "Financially, I don't see how this company can survive. People need to be responsible and, from USDA's standpoint, they will be held responsible. . . . They broke the rules. That does not mean the rules are wrong. I believe the rules are adequate."

The hearing came 11 days after Agriculture officials ordered the recall of 143 million pounds of beef processed by Westland/Hallmark, including 37 million pounds that had gone to school lunch and other public nutrition programs. No illnesses have been linked to the recalled meat.

The Health Care Blog compares Hillary Clinton and Barack Obama's health-insurance proposals and finds little difference between them.

CancerMonthly.com compares the records on cancer of Clinton, Obama and John McCain.

I'm not endorsing either of these analyses (let alone a candidate), just passing them on for whatever they might be worth.

An American Heart Association study released today says sedentary women can benefit from even small amounts of exercise in ways that go beyond purely physical health.

Can you spare, say, 20 minutes a day for your health?

On Tuesday, the U.S. Supreme Court heard arguments in a case about the District of Columbia's decades-old laws banning new registration of handguns, outlawing concealed weapons and requiring that guns kept at home be unloaded and either disassembled or unlocked. It is the most important gun-rights case to reach the high court in decades.

The medical community considers gun violence to be a legal, a political and a public health issue. The New England Journal of Medicine has published three relevant articles online: an examination of the issue from a public health perspective, an analysis of the legal and constitutional issues and an editorial urging the high court to consider public-health as well as legal issues as it weighs the constitutionality of the District's laws.

What do you think the court should do, and why? To what extent do you think the public-health angle should be a part of the discussion?

After my story Saturday on how Greensboro Day staffers saved eighth-grader Chris Dalldorf's life with a portable defibrillator, I got several e-mails, including some containing information I thought merited wider distribution.

Dr. Michael Simmons, who was quoted in the story, wrote to stress the need to have portable defibrillators in all schools. Potentially fatal heart problems are no respecter of age, and some genetically-based heart problems have surfaced in otherwise healthy kids even younger than Chris (who turns 15 in April). The Guilford County Schools have devices in all high schools and middle schools, but relatively few elementary schools have them at this point. One angle from Greensboro Day that I didn't have room to include in my print story was that faculty/staff there bought devices with money forfeited from people's health-care reimbursement accounts -- money that was paid in but never pulled back out to pay health expenses. Linda Sudnik, the school nurse, urges people to think creatively about how these purchases might be paid for, and she's speaking from experience on that.

Joe Mullins e-mailed to point out that Jon Schner, the school director of sports medicine who was instrumental in reviving Chris, is a certified athletic trainer who is licensed by the state of North Carolina. He thinks it's a good idea to have at least one such licensed professional on the staffs of all secondary schools, although North Carolina does not currently require that.

Finally, I heard today from Shellie Wenhold, who used to live in Greensboro with her family before moving to Georgia in 2004. In October 2004, her son Jonathan, who had attended Jesse Wharton Elementary here, went into sudden cardiac arrest at his school in Georgia. The school did not have a defibrillator, and paramedics arrived with one roughly 10 to 12 minutes after Jonathan's collapse -- too late to prevent brain damage from loss of oxygen. Jonathan died after eight days in the hospital.

Ms. Wenhold wanted to make people aware of two organizations whose work falls into this area.

The Sudden Arrhythmia Death Syndromes Foundation seeks to prevent sudden death due to heart abnormalities and to support families who have lost a member to this disorder.

Parent Heart Watch is a national network of families who either have lost a child to sudden cardiac arrest or who have children at known risk for it. It keeps databases of children who have died because of sudden cardiac arrest and of children who suffered it but were saved.

Ms. Wenhold has been active in this area since losing her son. She and others even helped obtain a portable defibrillator for Jonathan's former school, Jesse Wharton.

If there's a lesson to be taken away from her sad story and what happened to Chris Dalldorf, it's that we need portable defibrillators in more places and we need more people trained in how to use them. (Schner and Sudnik demonstrated it for me -- it looks so easy even a klutz like me could do it.) Training in cardiopulmonary resuscitation also remains crucial. Schner estimates that only 4 to 6 percent of North Carolinians are trained in CPR. If I or one of my children went into sudden cardiac arrest, I'd prefer the odds be much, much higher.

UPDATE: Today (April 1) the New England Journal of Medicine publishes both a paper and an editorial about the potential benefits of having a portable defibrillator at home. Research showed no statistically significant benefit, and the editorial notes, "As usual, marketing of such devices is charging far ahead of science." The study and editorial did not address the potential benefits of having such devices in public places.

UPDATE: Welcome to all the visitors from Instapundit. Please make yourselves at home.

April is Public Health Month, and Guilford County's Department of Public Health, the state's first, has a whole slew of activities lined up to mark the month. You can see the list here.

From the state Department of Health and Human Services comes notice that on Wednesday, April 2, four more barbecue restaurants in Lexington, which promotes itself as the World Capital of Barbecue, are going smoke-free in observance of Kick Butts Day.

The four are John Wayne's Barbecue, Smokey Joe's Barbecue, the Barbeque House and Whitley's Restaurant. They join several other restaurants that went smoke-free earlier: Backcountry BBQ, The Barbecue Center, Lexington Barbecue and Henry James Family Dining.

To answer a question no one has asked yet, the restaurants will still be using hickory smoke to make their barbecue. So far as I know, any link between hickory smoke and cancer remains unproven. [insert rim shot here]

The New England Journal of Medicine has two pieces up stemming from a case now before the Supreme Court regarding the constitutionality of the District of Columbia's ban on handguns. The Bush Administration has urged the high court to rule the laws an unconstitutional violation of the Second Amendment.

One article, by a physician and public-health professional, looks at gun violence as a public health issue. It cites studies that undermine what it calls "myths" surrounding the benefits of widespread gun ownership.

The second piece, by a law professor, simply examines the constitutional issues (without touching on public health) in what strikes me as a logical and nuanced way. It concludes that the court might well strike the D.C. ban and would have a logical basis for doing so, albeit not one everyone would agree with.

The Journal also has published an editorial urging the justices to consider the public-health implications along with the constitutional questions.

Read these pieces and tell me what you think.

... you should see China's.

The Centers for Disease Control and Prevention held a teleconference on Thursday to talk about the flu season just past and to announce an important change in flu-shot recommendations. (Transcript here; New York Times article here.)

The 2007-08 season was worse than the preceding three seasons, the article said. The main reason was that the most virulent strain of flu virus wasn't exactly one of the ones covered by the flu vaccine, although the kind covered by the vaccine covered a slight variant.

It's important for the vaccine to be a good match for the predominant strains of flu virus. But they're sometimes difficult to match up because manufacturing vaccines must begin months before they will be needed -- time during which a totally new strain or variant of virus can emerge.

Here's the change: Up 'til now, the CDC has recommended that children between the ages of 5 and 18 be vaccinated only if they had high-risk medical conditions or if they lived in households in which it would be possible for them to infect someone with a high-risk medical condition. For 2008-09 if possible, and by 2009-10 for sure, the CDC is calling for all children between 5 and 18 to be vaccinated -- that's 30 million additional people.

Flu-shot manufacturers manufactured roughly 140 million doses of flu vaccine this past season. The CDC expects the supply to be greater next fall, although it won't know how much greater for about another month.

Remember the stakes: About 200,000 people get the flu in the U.S. every year, the CDC says, and about 36,000 people die of it.

The New England Journal of Medicine has posted an article online about the travails of the Food and Drug Administration. The agency has been criticized for its role in the withdrawal of Vioxx from the marketplace and recent problems with contaminated Heparin from China.

But we ask the FDA to do a lot with not very much:

The fundamental problem is that legislators have heaped more and more responsibility on the FDA without appropriately increasing its budget. Between 1988 and 2007, additional FDA responsibilities were imposed by 137 specific statutes, 18 statutes of general applicability, and 14 executive orders. At the same time, the FDA received a 2007 federal appropriation of only $1.57 billion -- less than 75% of the budget for the school district in its home county in Maryland, and about the same as the projected cost of the infamous Alaskan "bridge to nowhere." The number of federally appropriated personnel authorized for the FDA has decreased from 9167 in 1994 to 7856 in 2007. And the remaining personnel must work with inadequate information technology: 80% of the FDA's computer servers are more than 5 years old; critical clinical trial records are stored on paper in warehouses, largely inaccessible for analysis; and the information technology budget is about 40% of that for the Centers for Disease Control and Prevention.

More money may not be the answer; the answer may be redefining and limiting the FDA's role. I don't know. But it is clear that to do its job as currently defined, the FDA lacks adequate resources. In particular, it doesn't have enough staff to inspect the foreign facilities from which 80% -- yes, you read that right -- of our drugs and drug ingredients now come. Under the current circumstances, additional problems similar to that of the Heparin from China might be not just likely but inevitable.

UPDATE: Americans' confidence in the FDA "has hit rock bottom."

It's mosquito and tick season once again -- and with the rains we got in April, that actually means something. The Guilford County Department of Public Health has posted some helpful suggestions to deal with those problems, ranging from reducing their breeding areas to reducing your own chances of being bitten. Bug bites, in addition to hurting and/or itching, can spread disease, notably (from ticks) Rocky Mountain spotted fever, so this is something to take seriously.

Via the Wall Street Journal's Health Blog comes a mixed bag of news about tobacco. According to a report in the Journal of the American Medical Association (behind pay firewall; Harvard news release here), sales of cigarettes are down from 21.1 billion packs in 2000 to 17.4 billion in 2007.

However, sales of snuff, roll-your-own tobacco and small cigares are up by the equivalent of 1.1 billion packs of cigarettes, based on tobacco and nicotine content. So the public health benefits of reduced cigarette smoking are being somewhat diluted.

"The major factor in the apparent switch to non-cigarette products by smokers appears to be price -- with the federal tax on other forms of tobacco 1/10th that of cigarettes -- and the heavy attention given to campaigning against cigarette use but not against other forms of tobacco products in recent years," the news release states. It also points out that raising the price of tobacco has been the most effective way of reducing tobacco use in the U.S.

So don't be surprised if public-health advocates mount an effort to get the feds and states to raise their taxes on non-cigarette forms of tobacco.

My colleague Lorraine Ahearn forwarded to me an e-mail that, to judge from its indenting, has been sent to many places. It says insurance companies are trying to make mastectomies for breast cancer an outpatient procedure. It says women who have undergone such operations experience a great deal of pain and discomfort afterward and need to stay in the hospital at least two days afterward before being sent home. And it asks people to sign a petition in favor of a bill supposedly pending in Congress that would do just that.

I get lots of e-mails seeking signatures on petitions favoring or opposing this issue/bill or that, and a ton of them are hoaxes. (The alleged federal tax on e-mail is one example that still pops up from time to time.) So I wondered: Is this e-mail for real?

More or less, yes.

When I pay attention to mass e-mails at all, my first stop is usually the myth-busting Web site Snopes.com. I searched on the bill name mentioned in the e-mail, "Breast Cancer Patient Protection Act," and sure enough, Snopes had an entry.

There is such a bill, Snopes said, linking to both House and Senate versions. Similar bills have been introduced in previous Congresses but have died in committee. The current versions, H.R. 119 in the House and S. 459, are indeed sitting in committees, with no major action on either since their referral to committees earlier this year.

The petition referred to in the e-mail can be signed on a Web site run by the women-oriented cable network Lifetime TV here. That page also indicates that a House subcommittee had held a hearing on the bill May 21. That hearing is not reflected on the House link above, but that might just mean that that Web site doesn't consider a hearing, without a vote, to be a "major action."

Anyway, the petition is there if you want to sign it. (For the record, being no expert on breast cancer, I have no opinion on the bills.) Snopes also says, and I agree, that if you want movement on the bills, you probably also should get in touch with your congresscritter and senators. If you're not sure who they are, you can find out at House.gov and Senate.gov, respectively.