Nutrisystem Coupons
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Nutrisystem Coupons
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Nutrisystem Coupons
Chickenpox row
By Clare Murphy
Health reporter, BBC News
It is peak season for chickenpox – the highly-contagious, blistering virus which for most children is unpleasant and for a very few lethal. A safe and effective vaccine is available – why don’t we use it
The varicella vaccine is available privately, but the UK’s immunisation body decided last year against universal vaccination of children – as carried out in many developed countries – citing cost and the fear it could increase shingles, a reactivation of the virus, in older people.
Yet while a vaccine against shingles for the elderly may now be in the offing, removing at least one of the potential hurdles, all debates about childhood vaccines still take place under the shadow of the upset over the measles, mumps and rubella jab (MMR), sparked by a now discredited research paper over a decade ago.
Despite international confirmation of its safety, a small number of parents still refuse to give their child the jab – and many in the medical community believe this explains the reluctance of the authorities to introduce a brand new injection into the childhood immunisation schedule.
"This is what it’s really all about," says Professor Adam Finn, consultant in paediatric infectious diseases at Bristol Royal Hospital for Children.
"The fact is parents who should be able to protect their child against chickenpox, an entirely preventable, unpleasant disease, are being held hostage by a small minority.
"Chickenpox is a disease which stops children going to school, means parents have to take time off work, and for children who are already sick can be very severe. And for a small cost we could be rid of it."
Like the wind
Chickenpox is not referred to in medical literature before the 17th Century but it is thought to be an ancient condition whose name springs from the fact that the blisters resemble chick peas.
Cases of the disease are not recorded in this country, but they are thought to number about 600,000 a year, and by the age of 12 some 90% of us will have had it. There is speculation that it may be rising among the very young as increasing numbers attend nurseries where they are more likely to pick up infections.
When compared to what were once the other common illnesses of childhood, it is less serious than measles, for instance, but potentially more problematic than mumps.
CHICKENPOX FACTS- Caused by the varicella zoster virus
- Spreads through the air and direct contact with fluid from blisters
- Spots usually appear two-three weeks after contact
- Thought to number 600,000 cases per year
- Once infected, may return as shingles in later life
In healthy children, serious complications are not common, but in rare cases it can lead to septic shock as a result of the blisters becoming infected, as well as pneumonia and encephalitis.
In those children whose immune systems are compromised – those with leukaemia, for example – chickenpox can be a real problem. Half of these youngsters develop complications and some of those die.
Doctors can immunise as soon as a condition like leukaemia is diagnosed, but this is not risk free nor always effective.
And for pregnant mothers and their unborn babies, chickenpox can in extreme cases lead to foetal deformities – hence the warning in maternity wards for the infected to stay away.
Apart from the costs of hospitalisation, there are also the economic implications of parents taking sometimes weeks off work to care for back-to-back infections among siblings who are barred from schools and nurseries.
Germany introduced a vaccination programme against what it calls windpox, due to the speed with which it spreads, in 2004 after a study concluded that paying for vaccination out of the public pot would be more than compensated by fewer sickness payments to absent parents in the longer term.
It followed the lead of the Japan and the US, which were among the first nations to introduce universal vaccination back in the 1980s and 90s.
Shingles fears
And so far, the jury is still out however on whether a chickenpox vaccine would indeed increase the incidence of shingles, a reactivation of the dormant virus which can cause severe and persistent pain in adults.
The theory is that once a person has had chickenpox, every time they come into contact with an infected youngster their body’s defence system receives the equivalent of a booster jab, building up resistance against the disease.
If children no longer harboured the disease, a rise in shingles could in principle follow – although the data from countries where the chickenpox vaccine is established has yet to produce compelling evidence of this.
The UK’s immunisation committee – the JCVI – has in any event recommended that the over-70s be vaccinated against shingles, a programme which could come into effect by the end of the year.
This does not alleviate the reservations of Nigel Scott from the Shingles Support Society.
"In an ideal world we would vaccinate everyone over 50 against shingles and then go ahead with the childhood chickenpox vaccine, but we are not there yet. If we live till 85, half of us will get shingles, and for some people this can be very serious indeed – some describe the pain as absolutely unendurable.
"Let’s not forget that when parents have to take time off for their young children, increasingly adult children may have to take time off to care for sick, ageing parents."
Pox money
As for expense, the JCVI says in the "short term" the costs would outweigh the benefits.
"I don’t think we are ready for the debate yet – not until we get MMR rates back where they need to be"
Dr David Elliman
RCPCH
There are also priorities. Experts say a vaccine against another form of meningitis is likely to be given preference over chickenpox in the immediate future.
All talk of new vaccines takes place against a backdrop of MMR uptake rates which while resuming, still fall below those needed to confer immunity on the community.
The Lancet, the medical journal which published the original research linking MMR to autism in 1998, last month published a full retraction, while the General Medical Council ruled in January that Dr Andrew Wakefield, who suggested the link, acted "dishonestly and irresponsibly" in the course of his work.
"But I don’t think we can say it’s yet consigned to history, sadly," says Dr David Elliman, immunisation expert at the the Royal College of Paediatrics and Child Health (RCPCH).
"The chickenpox vaccine is definitely desirable, and I think it it will happen, but unfortunately I don’t think we are ready for the debate yet – not until we get MMR rates back where they need to be. We need to win that one first."
This article is from the BBC News website. © British Broadcasting Corporation, The BBC is not responsible for the content of external internet sites.
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Obesity risk
VIEWPOINT
Professor Tony Leeds
Specialist in obesity management,
Central Middlesex Hospital
A big increase in obesity threatens to cause health problems for millions of people across the world.
In this week’s Scrubbing Up, obesity expert Professor Tony Leeds warns that our weight problems could also put the lives of other people at risk.
" Britain is gripped by a much-publicised epidemic of obesity – one in four of us is clinically obese.
Many obese people face an increased risk of illnesses such as heart disease, diabetes and cancer. On average, their lives will be shortened by nine years. But some might be unwittingly putting the lives of others at risk too. These additional fatalities are occurring not in Britain’s cardiac units, but on the country’s roads, due to people falling asleep at the wheel of cars and lorries. But why is this – and how many of us are unwittingly potential killers It is because Britain has yet to wake up to the dangers of obstructive sleep apnoea (OSA). Sleep deprivation OSA may be more common than is realised, especially in people with type 2 diabetes, where one in four might be affected. It causes snoring, interrupted by pauses in breathing, and choking and gasping during sleep. This makes sleep disturbed and restless, and can leave people tired, irritable, forgetful and depressed. It also increases the risk that they will fall asleep at work – or while driving. OSA can be caused by structural abnormalities of the upper airway but obesity is a big risk factor. Extra fat next to the airway can increase pressure on the muscles which support the airway, raising the risk that it will narrow and become obstructed. "The lifestyle of many lorry drivers means that many are significantly overweight. They lead a sedentary lifestyle, keep unsocial hours and might have unhealthy diets"
A recent British Medical Journal study showed that losing weight by following a very low calorie diet led to significant improvements in symptoms in just seven weeks for 26 out of 30 obese men with moderate or severe OSA. A longer-term US study produced similar findings. But the risks of living with the condition were graphically illustrated by another study, which calculated that people with severe sleep apnoea were between six and 15 times more likely to be involved in a road traffic accident. Unhealthy lifestyle Lorry drivers seem to be particularly at risk. The typical lifestyle means many are significantly overweight – they lead a sedentary lifestyle, keep unsocial hours and might have unhealthy diets. One study found only 11% had a "healthy" body mass index – and half were above the obesity threshold. "Perhaps we should call for a campaign to alert all drivers to the importance of adequate sleep" Britain’s leading sleep experts believe that nearly one in six lorry drivers could have sleep apnoea – that’s nearly 80,000.
But difficulties when driving may be under-reported – perhaps for fear of losing their licence and livelihood. In a period of just four months, at least four cases came before UK courts of drivers of large goods vehicles accused of causing death by dangerous driving. All four drivers were suffering from sleep apnoea – diagnosed only after these terrible accidents. In one incident it was revealed that a lorry driver involved in a fatal crash had seen his doctor just five months before, complaining of tiredness – but sleep apnoea was not diagnosed.
Calculated by dividing weight in kilograms by height in metres squared
- Normal: 18.5 – 24.9
- Overweight: 25 – 29.9
- Obese: Above 30
At the inquest, the coroner called for a toughening of the licensing regimen for commercial drivers, including regular medical screening.
He also called for fast-track medical assessment of those involved in road traffic collisions – but stressed that a diagnosis of sleep apnoea was unlikely to force them off the roads.
Survey data and random inquiry suggest that falling asleep (even momentarily) while driving may be more common than we realise. Our lifestyles, TV and computer use nibble away at the hours of sleeping.
Perhaps we should call for a campaign to alert all drivers to the importance of adequate sleep, to the effect that being obese can have on sleep quality, and to the need for an immediate visit to the GP if sleep apnoea is suspected.
"
Have you had any of the experiences described in the article above How do you think we can make our roads safer
This article is from the BBC News website. © British Broadcasting Corporation, The BBC is not responsible for the content of external internet sites.
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Social care deal ‘dead in water’
By Nick Triggle
Health reporter, BBC News
Hopes of reaching a cross-party deal on funding social care appear to be dead in the water.
The three main parties are due to take part in talks hosted by the merged Age Concern and Help the Aged charity.
But despite pleas from council chiefs for unity, fresh rows about policy differences have erupted.
The Tories, who have dubbed one of the government’s proposals a death tax, also ruled out relaxing their position so a compromise deal can be reached.
The latest talks were organised on the back of a Department of Health summit three weeks ago which was boycotted by the Tories.
The meeting, which will involve senior local government officials, charities and older people, is likely to be the last opportunity for the parties to meet on the issue before the expected start of an election campaign next month.
WHERE THE PARTIES STAND- Labour – Put forward three proposals – all of which involve the state providing a basic level of care which would be topped up by either personal contributions, a voluntary insurance scheme or compulsory levy. The third option – dubbed a death tax – is said to be favoured by ministers
- Tories – Proposed an £8,000 voluntary insurance model to cover residential care costs. Now drawing up plans for a voluntary scheme to cover domestic care, such as help washing, eating and dressing in the home
- Lib Dems – Initially supportive of free personal care – like Scotland has introduced – but now want a "partnership" whereby state pays some and individual tops this up in some way. Open to compulsory levy
The issue has been brewing since ministers published a series of proposals last summer to reform England’s means-tested system, which most experts agree is falling apart.
Among the plans was the idea to introduce a compulsory levy, possibly up to £20,000, which could be taken from a person’s estate after death.
The Conservatives vehemently oppose this idea, dubbing it a "death tax".
They have claimed it would penalise families who want to look after elderly relatives themselves. Instead, they favour a voluntary scheme.
On the eve of Wednesday’s meeting, they put out new figures which suggested the true cost of the plan could amount to £30,000 if benefits such as attendance allowance are cut to help pay for a new system.
Shadow health secretary Andrew Lansley said: "Labour are going in completely the wrong direction."
Meanwhile, the Lib Dems said the Tories’ plans would only benefit the wealthy after calculating that two-thirds of pensioners do not have the £8,000 to pay for the insurance plan the party has proposed.
Norman Lamb, the Lib Dem health spokesman, said: "The reality is that Conservative social care plans are unworkable, unfair and unaffordable."
The Tories rejected the analysis.
‘Bun fight’
The claim and counterclaim came as social services directors urged the parties to stop the "political bun fight".
Jenny Owen, president of the Association of Directors of Adult Social Services, said: "We really need a united front on the issue. Whoever wins the election will be faced with reforming the system and that is why we need common ground."
She suggested a third way could be found whereby a voluntary scheme is introduced at first with a compulsory scheme kicking in if take-up reaches a significant proportion – perhaps 70% – of the eligible population.
While the government and Lib Dems are believed to be open to this option, the Tories dismissed it ahead of Wednesday’s meeting.
A spokesman for Mr Lansley said: "A compulsory scheme is a non-starter for us. The government now needs to publish its plan and we can debate it during the election and let the people decide."
The government has promised to set out its favoured option in the coming weeks.
But a Department of Health spokeswoman said any changes that may be made, including taking away current benefits such as attendance allowance, would be about making the system better.
She added: "It is premature to start second-guessing the blueprint we will shortly set out for a new National Care Service."
The stalemate between the parties comes as a poll of more than 1,000 adults by Age Concern and Help the Aged revealed that nine in 10 want politicians to work together to reform the system, with many saying it will be among the most important issues in the election.
This article is from the BBC News website. © British Broadcasting Corporation, The BBC is not responsible for the content of external internet sites.
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