Flu Kills Quickly, Taking Lives of 100 Healthy Children Annually

By SUSAN DONALDSON JAMES

Nov. 28, 2012

In just eight months at his new school in Rifle, Colo., Austin Booth made a name for himself as a star athlete, honor student and a popular classmate with a promising future.

But within six days after he contracted the flu last January, Austin was dead. He was 17. His parents had never even considered giving a flu shot to their otherwise healthy teen.

"It was flu season and we knew other kids who were sick and we didn't think that much about it," said his mother, Regina Booth, 42. "He was a healthy teenager."

"He was just one of those kids that excelled at everything," she said. "And he was the type of kid who made friends instantly."

"It was pretty tough -- and it seems like just yesterday," said Booth, who is 38 weeks pregnant and now annually immunizes her four other children, aged 3 to 16.

"Now that we are expecting a new baby, it protects us and the baby," she said.

Debunking Four of the Most Common Flu Shot Myths

Between 3,000 and 49,000 Americans die of influenza each year, according to the Centers for Disease Control and Prevention.More than 200,000 are hospitalized annually with flu-related complications like pneumonia.

In the past four years, the CDC has changed its recommendations and now urges all Americans six months and older get a flu shot. Children under the age of 9, who are getting immunized for the first time, should get two doses, one month apart.

Booth said she still cannot believe how sudden her son's death was. On Tuesday night, he had started and played a full basketball game. By Wednesday night, he was coughing up blood and was rushed to the hospital with pneumonia.

"They intubated him as he struggled to breathe," said his mother. "It was the last time I talked to him."

His father Carl, who worked on an oil rig and couldn't be reached, was never able to see his son conscious again. Austin was airlifted to St. Mary's Hospital in Grand Junction and at first, doctors thought he would survive.

But soon, his condition got worse -- even on "every antibiotic in the world" -- and Austin had to be taken off the ventilator and manually "bagged." Tests showed the teen positive for the virulent infection MRSA.

"Doctor's said it was a perfect storm of pneumonia and MRSA," said Booth. "He fought Thursday until Monday, but it was more than his body could handle."

Hundreds of Austin's new friends showed up for his funeral. The basketball team retired his #2 jersey and Austin was recognized with a school bench and a memory stone.

"We had never gotten the flu shot -- not any of us," she said. "We thought, we don't need it, we are healthy. If we get the shot it will make us sick."

Dr. William Schaffner, professor and chairman of preventive medicine at Vanderbilt University in Nashville, said that people are fooled into thinking that influenza, a serious respiratory infection, is just like a cold.

"People use the word 'flu' very casually to refer to a whole variety of winter illnesses, including a stuffy nose, and that tends to trivialize it," said Schaffner. "It is a serious viral infection -- it wreaks havoc on all the body's systems."

"Although it can be mild and often is, it is often very, very serious and can strike an otherwise normal child and put them in intensive care, usually within 48 hours."

The most serious complications occur among older people, but each year children die of the disease -- and "it's potentially preventable," according to Schaffner.

"While it is an imperfect vaccine, it is the best influenza vaccine at the present time," he said. Though it does not always prevent infection, because viruses change each year, it can "turn a more serious flu into a milder one, so you won't die."

With 120 million doses given each year in the U.S. alone, it is a "wonderfully safe" vaccine, whose only side effects can be a sore arm or, rarely, a day of fever. It cannot give a person the flu. "That's an urban myth," said Schaffner.

The vaccine is covered by insurance carriers and only costs about $30 out of pocket. But only about half of all children are immunized.

Advocacy efforts by the nonprofit organization Families Fighting the Fluwere part the gradual change of the CDC recommendation toward universal immunization.

About 100 American children die each year from the flu, according to its executive director, Laura Scott. "It's devastating."

"The more people who get vaccinated, the less disease there is that spreads," said Scott. "You can build a cocoon around your family. Even if you don't have the infant vaccinated, you still have to vaccinate everyone around that baby."

Julie Moise of Kansas City, Mo., lost her 7-month-old son Ian to the flu in 2003. He got sick just 10 days after he had received his first of two flu shots. Her other children had full doses of the vaccine and never got sick.

Moise, a 41-year-old flight attendant, said she was initially "unconcerned" when Ian was diagnosed with the flu by his pediatrician. But by the end of the first day, he was "panting." The doctor reassured her that was normal in a child with a fever.

"His panting turned into more of a sigh and I thought that was a good thing," said Moise. "But later the doctor told me that happens when people's organs are shutting down."

Moise, too, was bedridden with the flu and called her husband to come home from work and help. She called the doctor's office again.

"Glen walks in the door and the phone rings -- it's the nurse," she said. "He told her, 'I don't like his coloring, let's take him to the emergency room.' Then Ian stopped breathing."

Moise, who is trained in CPR, attempted to save Ian while they rushed to the ER. They stopped at a nearby fire station and rescue workers also tried unsuccessfully to revive the baby. He died that afternoon at the hospital.

"The message is: First of all, take the flu seriously," she said. "We didn't think healthy children die of the flu. It's a preventable disease … And it doesn't discriminate. It can hit anyone."

After their son's death, the Moises founded Ian's Rainbow Flu Foundationto raise awareness.

Those who have survived influenza say its effects can be devastating.

Luke Duvall, now 20, came down with the flu in October 2009, and it took him a whole year to recover fully.

One-third of his Atkins, Ark., high school was hit hard with that strain of the flu.

Duvall was rushed to the hospital by ambulance. He nearly collapsed in the shower because he couldn't breathe.

"My blood pressure was so low that they couldn't draw blood and I almost crashed in the ambulance on the road," he said. "They had to pull over and stabilize me."

The next morning he was flown to Little Rock, where he stayed for 34 days, much of the time in a coma and on a respirator. "At one time, they had 20 IVs pumping all kinds of things into me," he said.

Duvall spent 17 days in rehab because he had lost 36 of his 157 pounds. "I had to relearn how to walk and how to drink and eat," he said. "I had to relearn daily functions like dressing myself."

All this, according to Duvall, because one student who boarded a football bus for a game had the flu and infected the entire team.

"He was a star athlete," he said. "If he had just had the vaccine, all of this would have stopped. It would have ended there. You don't just get it for yourself, but for those around you. It's a cycle that keeps going."

ABC News information specialist Nicholas Tucker contributed to this report.

http://abcnews.go.com/Health/ColdandFlu/flu-claims-lives-100-children-year-deaths-preventable/story?id=17820500&page=2#.ULYI_uQsDp8

Youth HIV Rate High, Testing Low

By MICHAEL SMITH, MedPage Today Staff Writer

Nov. 27, 2012

Americans between the ages of 13 and 24 accounted for more than a quarter of new HIV infections in 2010 -- about 12,000 cases -- but only a third of that age group had ever been tested for the virus, the CDC reported.

"This is our future generation, and the bottom line is that every month, 1,000 youth are becoming infected with HIV," said Dr. Thomas Frieden, director of the agency.

The "shocking" data, reported in a Vital Signs article from Morbidity and Mortality Weekly Report, detail the prevalence, incidence, and risk factors of HIV among youths, Frieden said in a teleconference with reporters.

Read this story on www.medpagetoday.com.

One implication of the new incidence data is a growing future healthcare burden, Frieden said.

Noting that the lifetime cost of care for a person with HIV is about $400,000, he said: "Every month we are accruing about $400 million of healthcare costs -- and every year $5 billion -- from preventable infections in youth."

"It is just unacceptable that young people are becoming infected at such high rates," Frieden said.

CDC researchers used surveillance data to analyze 2009 prevalence rates of diagnosed HIV among youths and the number of new infections in the 13 to 24 age group in 2010.

They also assessed the prevalence of risk factors and HIV testing among youths, both those still in high school and those 18 through 24.

They found that in 2009, the prevalence of HIV among youth was 69.5 per 100,000 population, with a state-by-state range from 2.3 to 562.8 per 100,000.

The rates were higher in southern and northeastern states compared with the West and Midwest.

Also, of the estimated 47,500 new HIV infections in 2010, 12,200 (25.7 percent) were among youths.

More than four-fifths of the new infections in 2010 (82.8 percent) were acquired by males.

Among newly infected youth, 57.4 percent were African American, 19.6 percent were Hispanics, and 19.5 percent were white.

Male-to-male sexual contact accounted for 72.1 percent of infections, while 19.8 percent were because of heterosexual contact. Injection drug use accounted for 4 percent, and 3.7 percent of infections were due to a combination of male-to-male sex and injection drug use.

Among males, 87.1 percent of infections were attributed to male/male sex, while among females, 85.7 percent were attributed to heterosexual contact.

Overall, youths with HIV made up 6.7 percent of the 1.1 million HIV-positive people in the U.S., the agency reported, and 59.5 percent of those did not know they were infected.

"That's a much higher proportion than the less than the 20 percent we estimate overall don't know they are HIV-infected," Frieden said.

The agency used data from 12 states and nine large urban school districts, collected in 2009 and 2011, to analyze risk behaviors among male and female students in grades 9 through 12.

Males who reported sexual contact with other males, the CDC found, reported more risky behavior than other youths.

For instance, they were more likely to report sexual intercourse with four or more persons during their lifetime (39.4 percent versus 26.9 percent) and to have ever injected any illegal drug (20.4 percent versus 2.9 percent).

Importantly, they were also significantly less likely to have used a condom during last their sexual intercourse (44.3 percent versus 70.2 percent), the agency reported.

They were less likely to report having ever been taught in school about AIDS or HIV infection (74.6 percent versus 86.3 percent), the CDC found.

Overall, in 2011, 12.9 percent of all students in grades 9 through 12 reported that they had ever been tested for HIV, but the proportion reached 22.2 percent among those who reported being sexually active (49.2 percent of males and 45.6 percent of females).

In the older group – those 18 through 24 -- 34.5 percent reported ever having been tested for HIV.

The CDC has recommended for several years that HIV testing should be part of routine medical care, but Frieden said many doctors still haven't bought into the idea.

"You have a very, very small proportion of who refuse testing," he said, "but unfortunately a relatively large proportion of doctors who don't make it routine."

http://abcnews.go.com/Health/AIDS/youth-hiv-rate-high-testing-low/story?id=17821912#.ULYHkeQsDp8

Orange Juice’s ‘Secret Ingredient’ Worries Some Health-Minded Moms

Orange Juice’s ‘Secret Ingredient’ Worries Some Health-Minded Moms

Natalya Murakhver, a New York food writer and mother of an 18-month year old daughter, loved her premium brand orange juice — the “100 percent pure” and “not from concentrate” kind that comes in the colorful carton and tastes consistently delicious.

That is, until she said she learned from her first-time moms group that there’s a “secret ingredient” in all premium orange juices that companies are not required to put on their labeling.

Now, after writing Whole Foods, she refuses to buy her favorite, “365″ juice, amid uncertainty about its contents.

“One of the moms said she had read about [how the juice is made] and they held it in tanks for up to a year and it pretty much lost all of its flavor and had to be reinvigorated with these flavor packs, which are essentially chemicals,” said Murakhver, 40, and co-author of “They Eat What?: A Cultural Encyclopedia of Weird and Exotic Food from around the World.”

For the last 30 years, the citrus industry has used flavor packs to process what the Food and Drug Administration identifies as “pasteurized” orange juice. That includes top brands such as Tropicana, Minute Maid, Simply Orange and Florida Natural, among others.

Murakhver said the addition of the flavor packs long after orange juice is stored actually makes those premium juices more like a concentrate, and consumers need to know that.

Experts estimate two-thirds of all Americans drink Florida orange juice for breakfast, and companies spend millions on their marketing campaigns touting its health benefits.

The “not from concentrate” brands appeared on store shelves sometime in the 1980s to differentiate them from frozen juice and other bottled concentrates. Despite its high price tag — now up to $4 a carton — sales of the premium brands have soared.

But those juices don’t just jump from the grove to the breakfast table.

After oranges are picked, they are shipped off to be processed. They are squeezed and pasteurized and, if they are not bound for frozen concentrate, are kept in aseptic storage, which involves stripping the juice of oxygen in a process called “deaeration,” and kept in million-gallon tanks for up to a year.

Before packaging and shipping, the juice is then jazzed up with an added flavor pack, gleaned from orange byproducts such as the peel and pulp, to compensate for the loss of taste and aroma during the heating process.

Different brands use different flavor packs to give their product its unique and always consistent taste. Minute Maid, for example, has a distinctive candy-sweet flavor.

Kristen Gunter, executive director of the Florida Citrus Processors Association,confirmed that juices are blended and stored and that flavor packs are added to pasteurized juice before shipping to stores.

Flavor packs are created from the volatile compounds that escape from the orange during the pasteurization step.

But, she said, “It’s not made in a lab or made in a chemical process, but comes through the physical process of boiling and capturing the [orange essence].”

The pasteurization process not only  makes the food safe, but stabilizes the juice, which in its fresh state separates. Adding the flavor packs ensures a consistent flavor.

The United States Department of Agriculture (USDA) grades the quality of the juice based on color, flavor and defects.

“To get grade A, we have to blend it,” she said. “Because oranges and their growing seasons vary, both the Valencia — ‘king of the oranges’ — and its lesser cousin, the Hamlin, are combined in the process.

“A processor is faced with harvesting the crop and giving the consumer some sense of what [he or she] might be getting,” she said. “You buy branded orange juice, you kind of want it to taste, generally, the same. That expectation is met by blending different varieties and, in order to blend, storage is involved.”

By  SUSAN DONALDSON JAMES

www.abcnews.go.com

Indian Internet users fear trend to oppression

Indian Internet users fear trend to oppression

India's growing community of Internet users are facing a crackdown from the government for speaking their minds. They are accused of scare-mongering and posing a threat to national security.

A day after the death of controversial Hindu nationalist politician Bal Thackeray last week, Shaheen Dhada, 21, wrote a status update on Facebook criticizing the lockdown in transport and services which had brought whole areas of Mumbai's to a grinding halt. Her friend Renu Srinivasan liked the comment.

The post was simple and to the point: "Every day thousands of people die. But still the world moves on. People like Thackeray are born and die daily and one should not observe a 'bandh' [shutdown] for that."

Religious organizations also want to ban social networking sites

The counter-attack was almost simultaneous. The medical student's remark drew strong reactions on the Net, the police came knocking and a 2,000-strong mob later vandalized her uncle's clinic. Following this, both Dhadha and Srinivasan were detained under the controversial Information Technology (IT) Act for 12 hours and later released on bail.

"I never expected this. Is India is a democratic nation? I didn't do anything wrong by sharing it (post). I am still to get over this and am dazed by the turn of events," Dhada told DW.

A warning to all

Barely had the dust settled on this unsavory episode when another case came to light where two airlines crew members, Mayank Mohan Sharma and K.V. J. Rao were arrested by the cyber crime cell of the Mumbai police in May 2012 for their Facebook comments.

The two reportedly spent 12 days in police custody and were then suspended by the national carrier, Air India.

The Indian government criticizes media for 'maligning' politicians

"We decided to end our silence for the first time after the harassment we faced. The police came to our house after midnight. We came out to tell our plight to the world after the arrest of the Mumbai girls," Mayank told DW.

Their crime - The two were accused of allegedly sharing bawdy jokes about politicians, made derogatory comments against the prime minister and insulting the national flag in their Facebook posts.

Prior to this, in October, a businessman from the southern region of Puducherry was arrested for a tweet against Finance Minister P. Chidambaramħ son, Karti. He was released on bail but the charges are yet to be dropped against him.

The arrests and the subsequent outrage has undoubtedly reopened the debate on free speech and highlighted the tensions individuals face from authorities for airing their views on an Internet that is becoming increasingly policed.

Controversial clause needs removal

Earlier it was social networking sites that faced the wrath of authorities when they were instructed to remove derogatory content for allegedly webcasting objectionable material. But the crackdown against individuals is disturbing to many rights activists.

The arrest of cartoonist Trivedi triggered a debate over India's free speech and press freedom

The outspoken chairman of the Press Council of India slammed the arrests: "We are living in a democracy, not a fascist dictatorship. In fact, the arrests themselves appear to be a criminal act, since ... it is a crime to wrongfully arrest or wrongfully confine someone who has committed no crime," said Markandey Katju Prasant Naidu, who is also an active blogger on social media news.

"I have the right to question a decision or share my thoughts which may not be liked by another group so does that mean I will be spending time in police custody. I do not support hate speech but then who draws the line?" Naidu queried.

The controversial clause of the IT Act states that a person will be punished for sending information on the internet that is rossly offensiver has a enacing character.

"'Grossly offensive or has menacing character are entirely subjective. Who are the police to decide? It will be a tool of harassment. Unless it is amended, every day there will be many committing offences in public life," Pavan Duggal, a cyber law expert told DW.

Following the uproar, Minister of Communications and Information Technology Kapil Sibal agreed that amendments would be needed to prevent misuse of the IT act. However, no deadline has been set which gives scope to the authorities using information on social networks to prosecute or persecute.

DW.DE

Germany rules against stem cell patents

Germany rules against stem cell patents

Should patents on the products of embryonic stem cell research be allowed? The European Court of Justice said no, but the question remained unanswered in Germany - until now.

The German constitution, called the Basic Law, guarantees the freedom of research. It also guarantees every human being the right to life. These two principles come into conflict when faced with the matter of human stem cell research. At least, they do if you take the view that life begins at conception rather than birth, because research is done using early-stage embryos, or more specifically the stem cells extracted from them. The embryos die during this process - though technology is being developed to prevent this.

The German parliament, the Bundestag, has introduced a law that places strict limits on this research. For instance, scientists can only use stem cell lines that were imported before May 1, 2007, a restriction meant to hinder the production of stem cells, and therefore the death of embryos, as a result of demand from Germany.

Oliver Brüstle took out a patent on a stem cell procedure

Patent rows

Some German scientists want to patent the results and developments they have invented through their stem cell research, and the Federal Court of Justice (BGH) pronounced a verdict on this legal question on Tuesday (27.11.2012). The court made clear that no patents may be issued on stem cell research if human embryos have been killed in the process. With that verdict, the court put itself in line with a ruling made by the European Court of Justice (ECJ) in 2011.

In 1999, Bonn-based researcher Oliver Brüstle took out a patent from the German Patent Office on a procedure by which so-called "neural precursor cells" can be extracted from stem cells. It was mainly a financial decision.

"The patent does not constitute permission to produce or sell, and it doesn't constitute permission to destroy embryos either," Tade Matthias Spranger, a lawyer specializing in bio-medical regulation, told Deutsche Welle. "The patent only bestows a single right - namely the inventor's right to deny commercial use to a third party."

European court's fundamental ruling

The environmental organization Greenpeace successfully challenged Brüstle's patent at the federal patent court in 2004, on the grounds of violation of moral principles. But Brüstle appealed, which brought the case before the BGH.

At first, the BGH referred the case to the ECJ in Luxembourg, to clarify the European law's interpretation, since there is an EU directive on patent law for stem cell research. This directive states that no patents may be issued for inventions whose commercial use would violate moral principles. This is especially true of the use of human embryos for industrial or commercial purposes. In an October 2011 ruling, the ECJ made clear that any product of research into human stem cells cannot be patented, if the embryos have to be killed for it.

The ruling will not impede scientific research, say some

No disadvantage to science

But in contrast to the question of patentability, there is no uniformity in Europe on the general legal stance on stem cell research. Britain, Sweden, and Belgium have very liberal rules - the UK even allows the production of human embryos for research purposes, under certain conditions. But the laws are much stricter in Germany, Norway, and Italy.

This patchwork of different legal situations has arisen because the legislative power on stem cell research lies in the hands of nation states. The EU has generally kept out of the debate up until now, and the latest German ruling will not change that.

Ingrid Schneider, political scientist specializing in the patenting of biotechnology at the University of Hamburg, does not believe that science has been weakened by this verdict. "It doesn't limit the freedom to research," she said. In fact, there could even be benefits for science: "The researchers don't have to make sure they are not violating any patents - they have the freedom to form their research."

DW.DE

Taking a walk in space

“Ready?”

I nod.

“Here we go…”

“Whoah!” is all I can manage as I find myself transported from a cluttered office in Houston to Earth orbit. Below, 350km (220 miles) away, the blue and white crescent of the Earth. Above me is the glistening white hull of the International Space Station (ISS), its vast solar arrays glinting in the sunshine.

Nasa hasn’t invented teleport. This is the agency’s Virtual Reality (VR) Laboratory at the Johnson Space Centre where dreams of space travel really can come true.

The lab complements underwater training and prepares astronauts for EVAs [Extra Vehicular Activity] – space walks – and work with robotic arms. Most of the room looks like a regular office with desks, computers and monitors but the rear section resembles an eccentric gym. Ropes hang from the ceiling, metal boxes are suspended on bungee cords and the room is criss-crossed by lines and pulleys.

“That’s where most of the virtual reality takes place,” says James Tinch, chief engineer for the Robotics Astronaut Office and manager of the lab. “The crewmembers put on the helmets and they get the sensation that they’re at the space station. The metal boxes with the ropes and pulleys tied to them are a mass handling device, so the crews can get a feel for what it takes to handle a large mass in space and how much trouble they might have just to move it around.”

I sit on the chair at the centre of the test area and Tinch gently lowers a harness over my shoulders. This holds the electronics for the virtual reality helmet, which he tightens around my head, allowing me to see an image of the VR environment. Next come the gloves. They look like cycling gloves and are fitted with sensors for grip and movement. I pull them onto my fingers. A box mounted to the ceiling above me will track their position as I move my hands around.

Then Tinch clicks the start button and I’m in orbit reaching out to the handrail just outside the airlock. I truly feel that I’m in space and yet to look at me, I’m still sitting on a chair at the centre of a room.

“Right now you’re next to the ISS airlock, where the crew members come out,” says Tinch, calmly. But I’m feeling anything but calm as I struggle to comprehend my new surroundings.

Try before you buy

If I look down I can see the rest of my spacesuit; straight ahead and there are my hands, now encased in astronaut gloves, tightly clasping the handrail. After giving me a few minutes to get acquainted with the view, Tinch instructs me to try to pull myself across one of the space station modules by releasing my left hand from the rail and gripping again further along. The idea is to pull myself around, hand over hand. But I let go too quickly and end up pushing myself away. I try to ‘swim’ back towards the structure, waving my hands wildly back and forth, but realise there’s nothing to push against. One of the major challenges of space walking – and a fuller understanding of Newton’s laws of motion – starts to become apparent.

“In space your hands pretty well do all your work for you,” says Tinch. “So your legs can kick and do anything but they’re not helping you.”

“One of the things you’ll find in space is that your wrist is one of the primary sources of how you move your body around, so astronauts do a lot of exercises with their hands and wrists to make sure they’re strong enough,” Tinch explains. “It’s a long day in those suits as you’re working against the suit and working against yourself, trying to get the work done.”

Quite how difficult space walking could prove to be was first brought home to Nasa in 1966, when astronaut Gene Cernan left the confines of the Gemini 9 spacecraft for the world’s third EVA. Later described by Cernan as “the spacewalk from hell,” he fought to control his tether and tumbled in a “slow motion ballet.” By the end, his heart rate had tripled, his visor had fogged up and he struggled to get back into the capsule.

Although I wasn’t in any danger (except perhaps from falling off my chair), forty-six years later, I experienced similar problems. If I moved my arm one way, my virtual body spun the other. The normal rules of movement that we are accustomed to on Earth do not apply in space. Imagine the simple act of tightening a bolt – without something to push against, as you turn the bolt you end up spinning in the opposite direction, achieving nothing. To overcome this problem, the ISS is fitted with handrails, footholds and often the crew will also use a robotic arm to assist them.

And they cannot just pop outside when the mood takes them. Lessons learnt over the years mean that every EVA is meticulously planned and choreographed. In fact, “space dance” might be a better way of describing what’s involved. Tinch explains that the VR lab enables astronauts to solve problems before they try it for real.

“If I have these four bolts I have to undo, what’s the best way for my body position to be? So you’re trying to do the choreography of the EVA and trying to figure out what works best for that workspace.” For those already on the ISS, the lab is developing VR helmets that can hook up to the station’s own laptops so astronauts can refresh their training on the job.

After 20 minutes in orbit, I’m exhausted. My back aches, my face is dripping with sweat and my wrists are sore. As he lifts off the helmet, Tinch assures me that astronauts trying this for the first time have similar problems.

If this were real, I would be wearing a bulky spacesuit, looking through a visor and would not have the luxury of stopping when I got a bit tired. The experience has given me a new appreciation of the training, skill and effort it takes to operate in the uncompromising space environment. A reality check for those of us who advocate manned missions to the Moon and Mars that we should never take this stuff for granted. Space walking may look like fun but, once you get over the amazing view, it is hard. Really hard.

In future columns Richard will be reporting from inside the space station control room and the full-sized mock-up of the ISS at Houston to discover what it takes to keep the astronauts alive.

http://www.bbc.com/future/story/20121123-taking-a-walk-in-space

Do flu vaccines give you flu?

In parts of the world where winter is approaching, this also heralds the start of the flu season. Over the last few weeks many people will have made a decision about whether or not to receive the latest vaccination against flu. Every year a new vaccine is produced, aimed at combating the latest strains of the virus. Recommendations vary from country to country, though many places target pregnant women and the elderly, as they are particularly at risk if they contract flu.

But every year doctors and practitioners encounter similar resistance from many people. How often have you heard people say that they’re convinced the flu jab gave them flu, or that the one year they were vaccinated they had the worst flu they’d ever had? They swear they’ll not be making the same mistake again. If you fall down with the flu after being vaccinated, you can see why you would be reluctant to receive it again, but is there any evidence that this is down to the vaccine itself?

Part of some people’s unease comes down to the nature of the vaccine. There are two types: an injection that contains an inactivated form of the virus; and a nasal spray that is becoming more common in places like the United States, which contains a live form of the virus, but in a much weakened form. Side-effects from the nasal spray can include a runny nose or sore throat. But the injection is not a live vaccine like, say, the rubella jab, where you are given a tiny amount of the infection to induce your immune system to create antibodies against it. The viruses involved in the flu vaccine are alive, but they are inactivated during production and batches of vaccine are tested to ensure that it is no longer virulent.

To study whether there are any side-effects in the days following a vaccination, US researchers vaccinated two thousand people, but only half were given the real vaccine, while the other half were injected with harmless salt water. There was just one side-effect reported more frequently by those who had received the genuine vaccine, and this wassoreness in the arm in which the injection had been given. Health authorities warn that occasionally people feel slightly feverish or achey afterward. This is a rare side-effect, but it still doesn’t mean that people have flu.

Prediction test
So what’s the explanation for the people who find they get flu within days of vaccination? It takes two weeks for immunity against the virus to develop, so these people could have contracted flu just before or after they had the vaccination. Research such as the US study shows that no more people develop flu symptoms than those who had salt-water injections. It is simply that a proportion of people vaccinated were already about to get flu. 

But what about the people who get flu during the winter, despite having received a vaccination? Are they somehow more susceptible to the illness, as many people think? The answer is that this is less about susceptibility and more about how the vaccines are created.

Each year the World Health Organisation selects the three viruses they believe will be most likely to be circulating the upcoming winter season in the northern or southern hemisphere. The selection for the northern hemisphere is announced in February, and vaccine production begins in March, ready for people to be immunised in the autumn. (Here’s the WHO’s latest recommendations for vaccines in the northern and southernhemisphere.) They are effectively making an informed prediction on the strains, but there is always the possibility that the flu virus you catch won’t be one of these three. And this is why it is never claimed that the vaccines are 100 % effective.

All of which begs the obvious question – how effective are they? Different studies are hard to compare because they measure different outcomes. Some look at rates of hospitalisation, others at death rates or at the number of laboratory-confirmed flu infections. But to take an example, a large study from 2007 published in the highly regarded journal, The New England Journal of Medicine found the vaccine protected seven out of ten people. Protection also varies from year to year, depending on the accuracy of the WHO’s predictions. Preliminary data from the US Centers for Disease Control estimate that the 2010/2011 flu vaccine was approximately 60% effective.

Persistent fear

That said, some people respond to the vaccine better than others, and this can depend on age. Protection is lower for those over 65, but the consequences of contracting flu can be more severe, which is why older people are targeted for vaccination. If people get flu despite having the vaccine, it’s not that vaccine gave them flu that winter, but that it didn’t protect them against it. And if you do get flu despite having had the vaccine, the chances are it would have been more severe without it.

Then there is another possibility, which is that you have a cold. And as horrible as it might feel, this is not the same as flu. There is a tendency to describe a bad cold as flu in order to convey to people quite how ill you are. I’ve done it myself. But the first time I had real flu I realised the difference. When I was recovering I made the mistake of going to rent a DVD from a shop five minutes walk away. The whole trip proved so exhausting that I had to sit on a bench for an hour to muster the energy to get back home. Colds and flu can both can involve sneezing, coughing and aching muscles, but flu usually comes on much more quickly, often starting with a sudden fever.

Yet despite the evidence available, many people remain convinced that vaccines can cause flu. In a study conducted by health psychologist Lynne Myers last year – not on the seasonal flu vaccine, but on the swine flu vaccine – only 53% of people surveyed correctly answered that the vaccine can’t cause swine flu. The evidence may be in favour of the vaccines, but the problem is that when we experience symptoms ourselves we make assumptions based on our own ideas about causality. It’s very hard not to connect events when the timing seems to fit. But that doesn’t always mean we’re right.

If you would like to comment on this article or anything else you have seen on Future, head over to our Facebook page or message us onTwitter.

You can hear more Medical Myths on Health Check on the BBC World Service.

DisclaimerAll content within this column is provided for general information only, and should not be treated as a substitute for the medical advice of your own doctor or any other health care professional. The BBC is not responsible or liable for any diagnosis made by a user based on the content of this site. The BBC is not liable for the contents of any external internet sites listed, nor does it endorse any commercial product or service mentioned or advised on any of the sites. Always consult your own GP if you're in any way concerned about your health.

http://www.bbc.com/future/story/20121126-do-flu-vaccines-give-you-flu

Skylon spaceplane engine concept achieves key milestone

By Jonathan AmosScience correspondent, BBC News

Skylon would do the job of a big rocket but operate like an airliner from a conventional runway

Continue reading the main story

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The UK company developing an engine for a new type of spaceplane says it has successfully demonstrated the power unit's enabling technology.

Reaction Engines Ltd (REL) of Culham, Oxfordshire, ran a series of tests on key elements of its Sabre propulsion system under the independent eye of the European Space Agency (Esa).

Esa's experts have confirmed that all the demonstration objectives were met.

REL claims the major technical obstacle to its ideas has now been removed.

"This is a big moment; it really is quite a big step forward in propulsion," said Alan Bond, the driving force behind the Sabre engine concept.

The company must now raise the £250m needed to complete the next phase of development.

This would essentially take the project to the final designs that could be handed to a manufacturer.

Although the British government has put significant sums into REL's technology in the past, the company's preference is to pursue city finance.

"The project to date has been more than 90% privately funded, and we intend to continue with that type of structure," explained Tim Hayter, the CEO of Reaction Engines Ltd.

"Yes, we would encourage government money but we're not reliant on it and we're certainly not depending on it.

"What is more important to us is government endorsement. That gives everyone the confidence that the UK is behind this project."

REL's idea is for an 84m-long vehicle called Skylon that would do the job of a big rocket but operate like an airliner, taking off and landing at a conventional runway.

The vehicle would burn a mixture of hydrogen and oxygen but in the low atmosphere the oxygen would be taken from the air, in the same way that a jet engine breathes air.

The pre-cooler demonstration was a critical step in proving the Skylon concept

Only once it had achieved very high speeds would Skylon switch to full rocket mode, burning onboard fuel supplies.

Taking its oxygen from the air in the initial flight phase would mean Skylon could fly lighter from the outset with a higher thrust-to-weight ratio, enabling it to make a single leap to orbit, rather than using and dumping propellant stages on the ascent - as is the case with current expendable rockets.

If such a vehicle could be made to work, its reusability should transform the costs of accessing space.

But its success depends on the Sabre engine's ability to manage the very hot air entering its intakes at high speed.

These gases have to be cooled prior to being compressed and burnt with the onboard hydrogen.

REL's solution is a module containing arrays of extremely fine piping that can extract the heat and plunge the inrushing air to minus 140C in just 1/100th of a second.

Ordinarily, the moisture in the air would be expected to freeze out rapidly, covering the piping in a blanket of frost and dislocating their operation.

But the company's engineers have also devised a means to control the frosting, permitting the Sabre engine to run in jet mode for as long as is needed before making the transition to full rocket mode to take the Skylon spaceplane into orbit.

It is the innovative helium cooling loop with its pre-cooler heat-exchanger that REL has been validating on an experimental rig.

"We completed the programme by getting down to -150C, running for 10 minutes," said Mr Bond. "We've demonstrated that the pre-cooler is behaving absolutely as predicted."

A concept drawing of the Sabre engine with a series of pre-cooler modules

The UK Space Agency asked Esa's propulsion division to audit the tests, and the Paris-based organisation has declared its satisfaction with the outcome of the experimental programme.

"One of the major obstacles to developing air-breathing engines for launch vehicles is the development of the lightweight high-performance heat exchangers," it said in a statement.

"With this now successfully demonstrated by REL, there are currently no technical reasons why the Sabre engine programme cannot move forward into the next stage of development."

The next phase is a three-and-a-half-year project. It would see a smaller version of Sabre being built on a test rig. The demonstrator would not have the exact same configuration as the eventual engine but it would allow REL to prove Sabre's performance across its air-breathing and rocket modes.

"Its parts will be spread out slightly; there's no need for us to package it as we would a real engine," said Mr Bond.

"Also, we will want the ease of access to exchange parts, so it will look a little bit like an anatomy exhibition."

The UK government is currently assessing what shape any involvement it should have in the next phase of Skylon/Sabre.

In addition, Esa is keen to do some study work with REL. Although it is currently working on new versions of its Ariane rocket - a classic expendable vehicle - the agency also wants keep an eye on future launcher technologies.

Sabre engine: How the test campaign was conducted

Continue reading the main story

Groundbreaking pre-cooler

• 1. Pre-cooler

  During flight air enters the pre-cooler. In 1/100th of a second a network of fine piping inside the pre-cooler drops the air's temperature by well over 100C. Very cold helium in the piping makes this possible.

• 2. Jet engine

  Oxygen chilled in the pre-cooler by the helium is compressed and used to fuel the aircraft. In the test run, a jet engine is used to draw air into the pre-cooler, so the technology can be demonstrated.

• 3. The silencer

  The helium must be kept chilled. So, it is pumped through a nitrogen boiler. For the test, water is used to dampen the noise from the exhaust gases. Clouds of steam are produced as the water is vapourised.

Jonathan.Amos-INTERNET@bbc.co.uk and follow me on Twitter:@BBCAmos

http://www.bbc.co.uk/news/science-environment-20510112

Rewards set to halve for digital money miners

Bitcoin "miners" generate the coins by completing work on a computer

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People trying to profit via the bitcoin electronic currency will soon have to work harder to mint the digital coins.

Safeguards built into the bitcoin software are about to be triggered as the number of bitcoins in circulation hits a key milestone.

This means bitcoin "miners" will have to work twice as hard to be rewarded with the same number of coins.

The change comes as competition to create the coins gets more intense with the release of custom mining chips.

Since the creation of the bitcoin network in early 2009, bitcoins have grown to become a very widely used digital currency. An increasing number of online shops and businesses accept bitcoins as payments and currently each bitcoin is worth about £8.

As a digital currency, bitcoins are not issued by a central bank or national mint. Instead they are created by the system's network when a specific amount of computer work, known as a "block" has been completed. Fifty bitcoins are released when that block is done and the work, which involves solving a hard mathematical problem, is completed.

The protocol that defines this block-to-coin ratio reduces the reward given for finding each block every time 210,000 blocks have been found. According to statistics gathered about the bitcoin network, the 210,000 figure looks set to be passed on 28 November. Then, instead of getting 50 bitcoins per block, miners will get only 25.

"The main reason to do this is to control inflation," said Vitalik Buterin, a journalist at Bitcoin Magazine. Controlling the rate at which coins were created, he said, meant there would never be a surge or shortfall in the number of bitcoins in circulation, either one of which could rapidly change the value of each coin.

It addition, he said, it was a hedge against technological innovation. In the early days of bitcoins, many people used desktop computers to do the hard sums. Then they started to use banks of graphics cards that could do the maths very quickly to speed up the rate at which blocks of work were completed.

Mr Buterin said some miners were now using even more specialised hardware to do the mathematical work and firms were starting to produce custom-made chips that stepped up the pace of work even more.

However, he said, the creators of bitcoins had foreseen these changes and built in controls to keep the numbers of blocks completed relatively constant.

"The protocol always calibrates difficulty to make up for increased mining power," he told the BBC, "so the speed at which people are finding blocks isn't going to go up by much no matter what."

http://www.bbc.co.uk/news/technology-20510447