Pandemic Influencia Update CDC

February 2, 2006

Public Interest in Avian Influenza Spikes:

On Jan. 24, 2006, the topic for The Oprah Winfrey Show was “Bird flu: The Untold Story.” The show aired locally at 4 p.m. Eastern time. The Oprah Winfrey Show entered national syndication in 1986, becoming the highest-rated talk show in television history. The show has remained the number one talk show for 19 consecutive seasons.

Public communication and health risk information are important elements of all pandemic influenza planning and response. During the Interpandemic Period, national, state, and local health communications professionals should focus on preparedness planning and on building flexible, sustainable communications networks. When health risks are uncertain, as likely will be the case during an influenza pandemic, people need information about what is known and unknown, as well as interim guidance to make decision to help protect their health and the health of others. For more information, visit: www.pandemicflu.gov.

*From: NCCD/DASH Inquiries [mailto:nccddashinfo@cdc.gov]
Sent: Thursday, February 02, 2006 4:06 PM
To: Comprehensive Health Education Network
Subject: [chen] PanFlu Newsletter 02-02-06

Daily Women's Health Policy

      Some San Diego County cities are considering further smoking regulations after the release of a report produced by the California Environmental Protection Agency and adopted last week by the state Air Resources Board that links secondhand smoke to breast cancer and reproductive health problems, the San Diego Union-Tribune reports (Lee, San Diego Union-Tribune, 2/1). The report, which was conducted by the CalEPA Office of Environmental Health Hazard Assessment, looked at more than 1,000 studies on the effects of secondhand smoke and finds that young women exposed to the smoke increased their risk for breast cancer by 68% to 120%. The report also finds that secondhand smoke can cause preterm deliveries and infants to be born with low birthweights. The Air Resources Board voted 6-0 to classify secondhand tobacco smoke as a "toxic air contaminant" after the report was released. ARB now has three years to consider whether possible regulations against secondhand smoke should be enforced in the state (Kaiser Daily Women's Health Policy Report, 1/27). Several anti-smoking groups in San Diego County are using the findings to push for new restrictions on smoking at trolley stops and on beaches and restaurant patios, as well as restrictions on drivers and condo and apartment residents, the Union-Tribune reports. According to an analysis of San Diego County released on Tuesday by the Tobacco Free Communities Coalition of San Diego and the American Lung Association of San Diego and Imperial Counties, about one-third of cities in the county have imposed further restrictions that prohibit smoking in workplaces and within 20 feet of entrances to government buildings (San Diego Union-Tribune, 2/2). However, the American Cancer Society, the National Cancer Institute and CDC have declined to endorse the CalEPA report, USA Today reports. Michael Thun, ACS' vice president of epidemiology, said that although a link between secondhand smoke and breast cancer is "certainly possible ... at this point, there is not broad scientific consensus." Jonathan Samet, a senior scientific editor of a U.S. surgeon general report on secondhand smoke, which is expected to be released later this year, said, "The scientific community is still watching for the evidence to evolve" (Ritter, USA Today, 2/2).

*http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=35154

Daily Women's Health Policy

      Staff at 35% of Catholic hospitals in New York, California, South Carolina and Washington state refused to provide emergency contraception to women who requested it, according to a survey released on Thursday by Washington, D.C.-based Catholics for a Free Choice, the Albany Times-Union reports (Morgan Bolton, Albany Times-Union, 2/3). According to the survey, Washington state, New York and California require all hospital emergency rooms to provide EC upon request, while South Carolina has a law that says the state will pay for "routine care of sexual assault patients," including EC (CFFC survey, January 2006). Women called 94 facilities to request EC in the four states, and staff said that they did not carry EC at the hospital 35% of the time, while 7% said EC was available to all women who requested it, the survey finds. About 20% of the hospital staff tried to avoid calls for EC, hung up on the callers or portrayed a negative attitude toward the women when they requested EC, the survey reports. New York Health Department spokesperson Robert Kenny said the department has received five complaints since January 2005 from people who were denied access to EC at hospitals, and two of the complaints that charged the hospitals with failing to provide sufficient medical care for sexual assault victims were confirmed. "The department periodically reviews a hospital's policies and protocols to determine their compliance with the law," Kenny said, adding, "State inspectors review this information as part of our ongoing surveillance efforts when investigating an incident or complaint of a similar nature at a hospital." CFFC President Frances Kissling said, "The results were mixed at best, and devastating at worst," adding, "That the Catholic hospitals we surveyed would turn women away in their time of need ... is not only a violation of the law, it is a violation of their mission" (Albany Times-Union, 2/3).

*http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=35181

Daily Women's Health Policy

      Infants exposed to antidepressants in utero are at risk of developing neonatal abstinence syndrome, according to a study published on Monday in the Archives of Pediatrics and Adolescent Medicine, Reuters reports. According to Reuters, NAS is defined as a type of withdrawal, distinguished by high-pitched crying, tremors and sleeping problems. Gil Klinger of Schneider Children's Medical Center of Israel and colleagues looked at 60 infants who were exposed to antidepressants in utero and 60 who were not exposed (Reuters, 2/6). Of the 60 exposed infants, eight exhibited severe NAS symptoms and 10 exhibited mild NAS symptoms. All of the 60 infants who were not exposed to antidepressants were designated as "normal" (Klinger et al., Archives of Pediatrics and Adolescent Medicine, February 2006). According to researchers, NAS does not need treatment, but the "long-term effects of in utero exposure to [antidepressants] have not been demonstrated clearly" (Bakalar, New York Times, 2/7). The researchers also wrote, "Infants exposed to [antidepressants] should be closely monitored after birth by using a standardized protocol for a minimum of 48 hours," adding that infants, especially those who experience severe symptoms, should receive follow-up care to evaluate possible long-term effects of NAS (Reuters, 2/6).

*http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=35270

Daily Women's Health Policy

• "FY 2007 Budget Summary," Women's Policy, Inc.: The summary includes information on how President Bush's proposed fiscal year 2007 budget would affect programs aimed at women and their families. The summary includes information about funding for abstinence-only education, HIV/AIDS programs, community health centers, family planning, and maternal and child health initiatives (Women's Policy, Inc., "FY 2007 Budget Summary," 2/8).

http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=35335

NEW PARTNERSHIP FOCUSES ON MAINTENANCE OF HEALTHY WEIGHT AMONG WOMEN OF CHILDBEARING AGE

February 10, 2006

Promoting Healthy Weight Among Women of Reproductive Age outlines factors that influence weight, demographics of weight among women of reproductive age, and the impact of overweight and obesity on perinatal outcomes. The paper was produced by the Association of Maternal and Child Health Programs and CityMatCH Women's Health Partnership, a project to build state and local capacity to promote safe motherhood and enhance women's health before, during, and after pregnancy. A description of the theoretical frameworks underpinning the AMCHP/CityMaTCH project efforts are presented, along with resources and community-based interventions for assisting women of reproductive age to maintain a healthy weight. The paper is available at http://www.amchp.org/aboutamchp/publications/Healthy%20Weight.pdf.

*MCH Alert-Tomorrow's Policy Today-Maternal and Child Health Library

ARTICLE LOOKS AT RELATIONSHIP BETWEEN SOCIAL SUPPORT AND ALCOHOL USE IN PREGNANT WOMEN

February 10, 2006

"In this sample of well-educated and employed pregnant women and their partners, social support was not predictive of prenatal alcohol use,"
state the authors of an article published in the January 2006 issue of the Journal of Women?s Health. Maternal psychological stress has been identified as an independent risk factor for preterm birth, low birthweight, and other pregnancy complications. The adverse impact of such stress, however, can be ameliorated by social support, defined as the psychological, emotional, and maternal assistance offered by the social network of family, friends, and community. Some have reported a potential relationship between lack of social support during pregnancy and use of alcohol and other substances. The purpose of the study described in this article was to evaluate the degree, predictors, and consequences of social support in a cohort of pregnant women who scored
2 or more on the T-ACE, a four-item screening questionnaire for prenatal drinking.

Study subjects were 200 women and their husbands or the biological fathers of the index pregnancy. Most women enrolled with a median gestation of 11.5 weeks (range: 4-27). Three potential outcomes of social support were examined: (1) infant birthweight, (2) average number of drinks per day, and (3) percentage of drinking days after study enrollment until delivery. The women completed the Maternal Social Support Index (MSSI) at the time of study enrollment.

The authors found that:

* Characteristics that increased overall maternal social support were the woman's being married, having more education, and having a job that was more prestigious than her partner's.

* Characteristics that decreased overall maternal social support were first pregnancy and increased woman's age.

* Social support was not predictive of prenatal alcohol use or birthweight.

* Early pregnancy drinking prior to study enrollment was the most predictive of subsequent consumption, whether measured by quantity or frequency.

* Marital status predicted prenatal drinks per day, whereas lifetime alcohol use predicted percentage of prenatal drinking days.

The authors concluded that "prior use and early pregnancy drinking were the most predictive of subsequent prenatal consumption, underscoring the importance of screening pregnant women for drinking."

*McNamara TK, Orav J, Wilkins-Haug L, et al. 2006. Social support and prenatal alcohol abuse. Journal of Women?s Health 25(1):70-76. Available at http://www.liebertonline.com/doi/abs/10.1089/jwh.2006.15.70.Readers: More information is available from the MCH Library's annotated bibliography, Substance Abuse During Pregnancy, at http://www.mchlibrary.info/action.lasso?-database=Biblio&-layout=Web&-response=/databases/BibLists/bib_subabusepreg.html&-MaxRecords=all&-DoScript=auto_
search_subabusepreg&-search.

Daily Women's Health Policy

      President Bush's budget proposal for the first time since he took office includes "sharp cuts" for funding of international family planning programs, which the Bush administration previously said were "one of the best ways to prevent abortion," the New York Times reports. Bush since 2001 has said he would maintain the funding of such programs at $425 million, according to a White House news release (Dugger, New York Times, 2/15). Bush five years ago reinstated the "Global Gag Rule," also known as the Mexico City Policy, which prohibits federal funds from going to abortion services overseas and denies family planning aid to international organizations that use their own funds to provide abortion counseling or services. The approximately $425 million went to overseas organizations in developing countries to promote family planning, and most was used for nutrition and counseling, advocates said, adding that the gag rule might limit the family planning money that is available (Kaiser Daily Women's Health Policy Report, 1/23/01). According to fiscal year 2007 budget proposal figures that Ed Fox, an assistant administrator at USAID, provided Wednesday as part of a comprehensive estimate of financing from the State Department and USAID, the FY 2007 budget proposal would reduce funding for overseas family planning programs 18%, from $436 million to $357 million. Fox said that other parts of the budget contain proposed increases for initiatives that will help women, such as programs to fight sexual violence against African women, HIV/AIDS and malaria. He added, "This is a much better budget than we've had in the past for women's health." However, Rep. Nita Lowey (D-N.Y.), who serves on the House Appropriations Committee, said, "It's ironic that an administration outwardly committed to reducing the incidence of abortion would take away valuable tools for preventing unwanted pregnancies" (New York Times, 2/15)

* http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=35423

Daily Women's Health Policy

      The South Dakota House on Friday voted 50-18 to approve an amended version of a bill (HB 1215) that would ban all abortions in the state except to save a pregnant woman's life and sent the bill to Gov. Mike Rounds (R), who has indicated support for the measure, the AP/San Diego Union-Tribune reports (Brokaw, AP/San Diego Union-Tribune, 2/24). While the bill would not punish a woman who underwent an abortion, it would make it a felony to perform one. Physicians convicted of performing the procedure would face a minimum of five years in prison and a $5,000 fine. Physicians who save the life of a woman by performing an abortion would not be charged with a crime as long as they make "reasonable medical efforts" to "preserve both the life of the mother and the life of her unborn child." Under changes made by the state Senate Affairs Committee, the bill states that "a pregnant mother and her unborn child each possess a natural and inalienable right to life" and due process under the South Dakota Constitution. The state Senate on Wednesday approved the measure.

Governor Rounds' Comments
Rounds issued a technical veto of a similar measure (HB 1191) in 2004 because he said it would have erased the state's current abortion restrictions while it faced a court challenge (Kaiser Daily Women's Health Policy Report, 2/23). Rounds during a news conference on Friday said he and his aides will study the bill to decide whether the language in the current legislation fixes the problem of the 2004 measure (Davey, New York Times, 2/25). "If the bill is correctly written, then I will seriously consider signing the bill," he said on Saturday, adding, "It would be a direct frontal assault on Roe v. Wade" -- the 1973 Supreme Court decision that effectively outlawed state abortion bans (Conlon, Reuters, 2/27). Rounds has 15 days to decide whether to sign the measure (Kaiser Daily Women's Health Policy Report, 2/23). If he does, the bill is scheduled to take effect on July 1 (New York Times, 2/25).

*http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=35635

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