Wall Street Journal – January 2008
GAO to Cite FDA Faults At Congressional Hearing
The Real FDA Scandal
We at Infinite Health Resources have long been critical of the FDA. On the other hand we also share FDA alerts and safety concerns on our website as this info becomes available from the FDA, which is weekly.
However, until the funding of the FDA is altered in some way to get Big Pharmaceuticals out of the nearly $500,000,000 it annually hands the FDA, we will continue to suffer adversely from much of their drug approval decision making.
In this global economy with imports from the world over. Much needed improvement in oversight is needed. This in our view is as threatening as securing our border from illegal immigration and possible terrorist infiltration.
Tainted food, toys and pet products have already been imported. These are just a few that were found. Surely there are more. More funding from the government to make sure a government agency, like the DFA, is operating sufficiently is long overdue.
This issue has not come to bare in our presidential campaign. Could those campaign dollars have anything to do with that? We wouldn’t bet the farm on it.
Read on:
GAO to Cite FDA Faults At Congressional Hearing
The Food and Drug Administration can’t keep up with requirements to inspect domestic makers of medical devices to assure manufacturing quality, and the agency rarely examines foreign companies, according to congressional investigators.
In testimony scheduled to be delivered today before a House Energy and Commerce subcommittee, the Government Accountability Office will tell lawmakers that it found “weaknesses” in the agency’s over-sight of an industry that makes products ranging from contact lenses to defibrillators. According to FDA officials’ own estimates, overseas makers of the riskiest products such as peacemakers, were examined only every 6 years, and moderate-risk device manufacturers on average went an estimated 27 years between FDA inspections.
The GAO testimony on medical devices will be part of the hearing’s broader effort to high-light an issue that has turned up in reports and critiques over the past few years: concerns the FDA’s resources and technology aren’t enough to meet its regulatory responsibilities to oversee drugs, food and other products.
The subcommittee also is expected to discuss a separate, harshly worded report released in November by a group of the FDA’s own advisers that warned the agency needs substantial resources to deal with emerging scientific developments.
The report, from a subcommittee of the FDA’s outside Science Board that included members and advisers from industry as well as academia, said the agency “cannot even keep up with advances in science.” An appendix to the report said the FDA conducted twice as many inspections of food facilities in 1973 as it did of all facilities – including food, drugs and medical devices – in 2006
The hearing also is expected to focus on the FDA’s oversight of food, an issue that has sparked concerns in the wake of recalls. The GAO will testify that the FDA’s plan to step up food regulation, unveiled last year, could help but the agency needs to issue more specifics. The FDA’s staff and resources haven’t kept up with the food-safety work load, the congressional investigators will say.
As the Bush administration comes close to releasing its proposed budget, the testimony will add weight to calls by some groups for a budget boost for the FDA.
An FDA spokeswoman said the agency will comment on the GAO testimony at the House hearing. She said the agency “appreciates the Science Board subcommittee’s efforts to draft a report” and will work with the full board on the issue.
Worries about the FDA’s fundings have been strong enough to spark a lobbying effort, first launched in 2006, that brought together industry and patient groups, as well as former agency officials. The money appreciated for the FDA by Congress for fiscal 2008, which ends October 1 was a bit more than 9% compared with the year before, according to Steven Grossman, deputy executive director of the Alliance for a stronger FDA.
The hearing also will highlight safety concerns that have been raised in several hearings by Michigan Democratic Representatives John Dingell and Bart Stupak, who are chairmen of the full Energy and Commerce panel and the Oversight and Investigations Subcommittee, respectively. Mr. Dingell has introduced a bill seeking to bolster inspections of imported food and drugs through new industry fees.
The medical-device testimony will say that FDA officials estimated U.S. markers of the highest risk products are examined, on average, every three years. Domestic manufacturers of moderate risk devices get inspected every five years. Overall, the GAO estimated, the FDA inspected about 27% of the registered U.S. manufacturers each year and about 5% of the foreign facilities.
In a statement, AdvaMed, a trade group that represents medical-device makers, said the industry “has an excellent safety record” and it supports “additional appropriations for FDA.”
The Real FDA Scandal
So Members of Congress and the press are working up another panic about the state of the Food and Drug Administration. The place is a mess all right, but as usual the most alarming news is receiving almost no attention.
Washington is responding to a series of investigations concluding that the FDA cannot "adequately" monitor America's food supply and medical products. One of the FDA's outside advisory panels, the Science Board, reports that the agency is in "a precarious position," in part because it is chronically underfunded. The Government Accountability Office chimes in that, at the FDA's current pace, it would take 13 years to inspect every foreign drug plant exporting to the U.S. and 1,900 years to inspect every overseas food factory.
That last factoid may be true, or not, but it does raise the question of whether such a crackdown is possible, never mind desirable. Monitoring 100% of foreign imports -- or 10%, or whatever -- would be so onerous that it might as well be a ban. Yet lapses like adulterated Chinese toothpaste are exceedingly rare, mainly because companies have every incentive to police themselves. (Ask Mattel about its toy import nightmare.)
Still, it's generally agreed that the FDA could use more cash, and the White House's 2009 budget requests a 5.7% increase. But what no one reports is that the Science Board says these shortfalls crop up because Congress hasn't increased FDA funding in proportion to its burgeoning regulatory demands. Over the last two decades, Congress has expanded the FDA's reach more than 127 times; it now oversees about 25 cents of every dollar spent in the U.S.
The Science Board's most important, and distressing, finding is that the FDA bureaucracy "cannot even keep up with the advances in science" -- and not solely due to a lack of funding. While "the world of drug discovery and development has undergone revolutionary change," the authors write, the FDA's "evaluation methods have remained largely unchanged over the last half-century." (Our emphasis.)
Think about that: We live amid a revolution in biology, but the FDA still thinks like it did when Sputnik launched.
The observation comes on page three, which leads us to suspect that Congress's hand-wringers haven't even read the study. Here's a refresher: "The mission of getting safe and effective drugs to patients in a timely manner is currently threatened by inadequate expertise and capabilities," the Science Board notes.
Particularly in complex and specialized fields like genomics and biotechnology medicine, the FDA lacks the basic competence "to understand the impact of product use, to maintain ongoing currency with their evolution or to evaluate the sophisticated products produced" and "to support innovation in the industries and markets that it regulates."
The Science Board authors propose that the FDA "modernize current regulatory pathways," especially the narrowness with which it balances risk and benefit for the most promising new therapies before they are allowed to reach the public.
The FDA uses rigid statistical techniques to evaluate developmental drugs, even when the lives of terminally ill patients are at stake. Many advanced immunotherapies for cancer, for instance, are held hostage to the FDA's old models, which still insist on crude mortality rates and the large average effects detected in clinical trials. Better metrics would include improving the quality of life or slowing the progression of tumors, or focusing on targeted populations. The Science Board says that "there is an urgent need for developing . . . new statistical methods that are most appropriate for the data generated by new areas of science."
Take Junovan, a medicine for a rare pediatric bone cancer. Junovan's successes in a clinical trial were "only" demonstrated with a 94% level of statistical certainty, instead of the FDA-mandated 95%. Avastin, a revolutionary biologic currently used against lung and colorectal cancers, also looks like it will get a thumbs-down as a treatment for metastatic breast cancer. While the evidence shows that patients lived longer before their symptoms got worse, they didn't live longer on average. Refusing to consider "progression-free survival" as a drug benefit is not only unscientific, but morally hideous.
The real scandal is that these policies are the product of the FDA's institutional culture, which puts political incentives and bureaucratic procedure above patient results. Congress and the press could do some good if they investigated that problem, but it's so much easier to say, "spend more money."
Perhaps that's why the Science Board ends on a mordant, but all too accurate, note: "Finding: Recommendations of excellent FDA reviews are seldom followed."Read more at www.infinitehealthresources.com, click the Resource Center.
Saturday, February 23, 2008
Keep The Veggies Coming
US News and World Report December 2007
Keep The Veggies Coming
By Nancy Shute
This article hits it right on the mark when it comes to children developing healthy eating habits from infancy.
Remember the old saying, the apple doesn’t fall far from the tree, no pun intended.
When it comes to food, smoking, drinking, sports like fishing, tennis and on and on. Monkey see, monkey do. Well that certainly holds true for eating.
On my website, www.infinitehealthresources.com, The Resource Center, I have written hundreds of thousands of words related to this topic. I am no expert, however I have been blessed with 4 healthy children and they have been eating healthy veggy filled meals since solid foods were introduced into their lives. Here’s the secret. Shut up, sit down and eat. They will too. Talk to your spouse about how good this food is in front of your child. How good this food makes you feel. They will eat.
Now if your diet is hamburgers and fries or mac and cheese, you’re screwed. Period.
Read on and hear from the experts:
Want your kids to eat their veggies? Start offering them when they’re tiny babies, and don’t take a grimace to mean “No.”
That’s the advice of Julie Mennella, a biopsychologist and expert on food choices at the Monell Chemical Senses Center in Philadelphia. She recently had 45 mothers spoon-feed their babies pureed green beans once daily. Half the group also offered pureed peaches afterwards. At first, the babies who got peaches ate more peaches then beans; after eight days, both groups were eating green beans and had increased their consumption twofold. “They’ll wrinkle their noses,” Mennella says, “but they still continue to eat.”
The babies who were breast-fed also ate more peaches than formula-fed babies, perhaps because their mothers ate more fruit than non-breast-feeding moms. This echoes Mennella’s earlier research, in which babies born to women who drank carrot juice in the third trimester favored cereal made with carrot juice, as did babies whose mothers drank carrot juice while breast-feeding. “It’s really a fundamental feature of all mammals,” Mennella says. “It’s the first way we learn about foods and flavors.”
Sweets please. It’s clear that children favor what their parents eat, whether it’s muktuk in Alaska or dal in New Delhi. When it comes to eating vegetables, that’s a problem, since most adults don’t eat the recommended two servings of fruit and three servings of vegetables daily.All humans relish fat and sugar, because they’re the most concentrated sources of energy in a world where, until very recently, hunger and famine were threats to almost everyone. Now, alas, it’s easy to supersize the fats and carbs, and still hard to choose celery over cookies. Nutritionists are well aware that parents aren’t always the best role models when it comes to healthful eating, and schools have lately tried to do a better job of encouraging wise choices, by putting water in vending machines and fresh fruit in the lunch line. Congress is now considering a federal ban on the sale of candy, sodas, and salty fatty food in school vending machines and cafeterias.
The eat-your-vegetables war has escalated recently, fueled by two new books that encourage parents to sneak vegetables into treats like brownies and chocolate pudding. Deceptively Delicious by Jessica Seinfeld (wife of the comedian Jerry) and The Sneaky Chef by Missy Chase Lapine have evoked howls from chefs and nutritionists for suggesting that slipping pureed cauliflower into macaroni and cheese is a good idea. There are two big problems here. One, this sends kids the message that brownies are sustenance, not an occasional treat. And two, it never gives children the chance to learn to appreciate vegetables for their own merit.
“You can’t mask the flavor if the goal is to get kids to eat fruits and vegetables,” Mennella argues. All the research points to this common-sense realization: the earlier and broader a child’s experience with a wide variety of foods, the more healthful the diet. A new book, Food Flights by peditricians Laura Jana and Jennifer Shu, offers practical strategies that are much more appealing than vegetable subterfuge – like requiring a “no (more), thank you” bite to audition to new foods.
I, too, depair when the lunch bag comes home at the end of the day with carrots and apple unmunched. But I also have discovered that Mennella’s theory works too. If I ooh and ah over the deliciousness of spinach salad, my preschooler will smack her lips as she pops leaves into her mouth. She still thinks a Chicken Mcnugget is a culinary marvel, alas. But she also now takes joy in green things that crunch.
Learn more about healthy diets and great references at www.infinitehelathresources.com, click on The Resource Center.
Keep The Veggies Coming
By Nancy Shute
This article hits it right on the mark when it comes to children developing healthy eating habits from infancy.
Remember the old saying, the apple doesn’t fall far from the tree, no pun intended.
When it comes to food, smoking, drinking, sports like fishing, tennis and on and on. Monkey see, monkey do. Well that certainly holds true for eating.
On my website, www.infinitehealthresources.com, The Resource Center, I have written hundreds of thousands of words related to this topic. I am no expert, however I have been blessed with 4 healthy children and they have been eating healthy veggy filled meals since solid foods were introduced into their lives. Here’s the secret. Shut up, sit down and eat. They will too. Talk to your spouse about how good this food is in front of your child. How good this food makes you feel. They will eat.
Now if your diet is hamburgers and fries or mac and cheese, you’re screwed. Period.
Read on and hear from the experts:
Want your kids to eat their veggies? Start offering them when they’re tiny babies, and don’t take a grimace to mean “No.”
That’s the advice of Julie Mennella, a biopsychologist and expert on food choices at the Monell Chemical Senses Center in Philadelphia. She recently had 45 mothers spoon-feed their babies pureed green beans once daily. Half the group also offered pureed peaches afterwards. At first, the babies who got peaches ate more peaches then beans; after eight days, both groups were eating green beans and had increased their consumption twofold. “They’ll wrinkle their noses,” Mennella says, “but they still continue to eat.”
The babies who were breast-fed also ate more peaches than formula-fed babies, perhaps because their mothers ate more fruit than non-breast-feeding moms. This echoes Mennella’s earlier research, in which babies born to women who drank carrot juice in the third trimester favored cereal made with carrot juice, as did babies whose mothers drank carrot juice while breast-feeding. “It’s really a fundamental feature of all mammals,” Mennella says. “It’s the first way we learn about foods and flavors.”
Sweets please. It’s clear that children favor what their parents eat, whether it’s muktuk in Alaska or dal in New Delhi. When it comes to eating vegetables, that’s a problem, since most adults don’t eat the recommended two servings of fruit and three servings of vegetables daily.All humans relish fat and sugar, because they’re the most concentrated sources of energy in a world where, until very recently, hunger and famine were threats to almost everyone. Now, alas, it’s easy to supersize the fats and carbs, and still hard to choose celery over cookies. Nutritionists are well aware that parents aren’t always the best role models when it comes to healthful eating, and schools have lately tried to do a better job of encouraging wise choices, by putting water in vending machines and fresh fruit in the lunch line. Congress is now considering a federal ban on the sale of candy, sodas, and salty fatty food in school vending machines and cafeterias.
The eat-your-vegetables war has escalated recently, fueled by two new books that encourage parents to sneak vegetables into treats like brownies and chocolate pudding. Deceptively Delicious by Jessica Seinfeld (wife of the comedian Jerry) and The Sneaky Chef by Missy Chase Lapine have evoked howls from chefs and nutritionists for suggesting that slipping pureed cauliflower into macaroni and cheese is a good idea. There are two big problems here. One, this sends kids the message that brownies are sustenance, not an occasional treat. And two, it never gives children the chance to learn to appreciate vegetables for their own merit.
“You can’t mask the flavor if the goal is to get kids to eat fruits and vegetables,” Mennella argues. All the research points to this common-sense realization: the earlier and broader a child’s experience with a wide variety of foods, the more healthful the diet. A new book, Food Flights by peditricians Laura Jana and Jennifer Shu, offers practical strategies that are much more appealing than vegetable subterfuge – like requiring a “no (more), thank you” bite to audition to new foods.
I, too, depair when the lunch bag comes home at the end of the day with carrots and apple unmunched. But I also have discovered that Mennella’s theory works too. If I ooh and ah over the deliciousness of spinach salad, my preschooler will smack her lips as she pops leaves into her mouth. She still thinks a Chicken Mcnugget is a culinary marvel, alas. But she also now takes joy in green things that crunch.
Learn more about healthy diets and great references at www.infinitehelathresources.com, click on The Resource Center.
Chemicals, contaminants, pollution, price: new reasons to Rethink What you Drink
Reader’s Digest, February 2008
Chemicals, contaminants, pollution, price: new reasons to Rethink What you Drink
By Janet Majeski Jemmott
Infinite Health Resources has written plenty about our domestic water supply. I have shared my own amazing discoveries about my drinking water in New York City over the last four years.
Janet Majeski Jemmott gets it right and to the point in what I consider a near perfect hit on our water supply. Although she mostly speaks in terms of drinking water, we all should be just as diligent about our bathing water. We all shower or bathe in the hottest water we can stand. Thereby creating steam. Two things happen. For beginners, our skin absorbs what we put on it, including bath water. The steam we breathe from this bath or shower water contains all the toxins and chemicals found at the tap.Let me share this story.
I installed an Aquasana Water Filter system on my showerhead. My son comes to me days later and says, “Dad, my eyes do not burn like they used to and my skin stopped itching.” I was shocked. I knew he had a weakness to chlorine because in the summer months, pool swimming was a problem for him. I knew chlorine and many other chemicals were in our water. New York City adds chlorine, fluoride and who knows what else to its municipal water supply. The water filter worked. So Filter your water people.
There is however one area in her article I do disagree with. Ms. Jemmott recommends adding fluoride to the daily water diet to supplement the lack of it from drinking filtered water. Fluoride is added to municipal water supplies, due to some oddball study 50 years ago that a town in the South Midwest had a few or no cavities. It was later discovered that fluoride was found in their water supply. So the powers that be decided to add it to every municipal water supply.
On our website, www.infinitehealthresources.com, we have published studies and lawsuits filed by EPA scientists who based on hard evidence disagree with these findings.
Fluoride is chemical byproduct found in the fertilizer manufacturing process. It is a toxic chemical. Period.
Think about this! What about all those millions of people who only have access to well water. There are millions of these people. Are they all walking around toothless or with dentures? Common sense is the basis for this theory.
Here is the link for our published articles on Fluoride
Read on. At the end there will be several links for more information on healthy water and water filters.
Chemicals, contaminants, pollution, price: new reasons to Rethink What you Drink
Growing ThirstRemember the drinking fountain, that once ubiquitous, and free, source of H2O? It seems quaint now. Instead, bottled water is everywhere, in offices, airplanes, stores, homes and restaurants across the country. We consumed over eight billion gallons of the stuff in 2006, a 10 percent increase from 2005. It's refreshing, calorie-free, convenient to carry around, tastier than some tap water and a heck of a lot healthier than sugary sodas. But more and more, people are questioning whether the water, and the package it comes in, is safe, or at least safer than tap water—and if the convenience is worth the environmental impact.
What's in That Bottle?Evocative names and labels depicting pastoral scenes have convinced us that the liquid is the purest drink around. "But no one should think that bottled water is better regulated, better protected or safer than tap," says Eric Goldstein, co-director of the urban program at the Natural Resources Defense Council (NRDC), a nonprofit organization devoted to protecting health and the environment.
Yes, some bottled water comes from sparkling springs and other pristine sources. But more than 25 percent of it comes from a municipal supply. The water is treated, purified and sold to us, often at a thousand fold increases in price. Most people are surprised to learn that they're drinking glorified tap water, but bottlers aren't required to list the source on the label.
This year Aquafina will begin stating on labels that its H2O comes from public water sources. And Nestlé Pure Life bottles will indicate whether the water comes from public, private or deep well sources. Dasani acknowledges on its website, but not on the label itself, that it draws from local water.
Labels can be misleading at best, deceptive at worst. In one notorious case, water coming from a well located near a hazardous waste site was sold to many bottlers. At least one of these companies labeled its product "spring water." In another case, H2O sold as "pure glacier water" came from a public water system in Alaska.
Lisa Ledwidge, 38, of Minneapolis, stopped drinking bottled water a couple of years ago, partly because she found out that many brands come from a municipal supply. "You're spending more per gallon than you would on gasoline for this thing that you can get out of the tap virtually for free," she says. "I wondered, Why am I spending this money while complaining about how much gas costs? But you don't ever hear anyone complain about the price of bottled water." Ledwidge says she now drinks only filtered tap water.
The controversy isn't simply about tap vs. bottled water; most people drink both, knowing the importance of plenty of water. What they may not know is that some bottled water may not be as pure as they expect. In 1999 the NRDC tested more than 1,000 bottles of 103 brands of water. (This is the most recent major report on bottled water safety.) While noting that most bottled water is safe, the organization found that at least one sample of a third of the brands contained bacterial or chemical contaminants, including carcinogens, in levels exceeding state or industry standards. Since the report, no major regulatory changes have been made and bottlers haven't drastically altered their procedures, so the risk is likely still there.
The NRDC found that samples of two brands were contaminated with phthalates, in one case exceeding Environmental Protection Agency (EPA) standards for tap water. These chemicals, used to make plastic softer, are found in cosmetics and fragrances, shower curtains, even baby toys, and are under increasing scrutiny. They're endocrine disrupters, which mean they block or mimic hormones, affecting the body's normal functions. And the effects of exposure to the widespread chemicals may add up.
When exposed to high levels of phthalates during critical developmental periods, male fetuses can have malformed reproductive organs, including undescended testicles. Some experts link phthalates to low sperm counts.
Water bottles do not contain the chemical, which means the phthalates detected by the NRDC probably got into the water during processing at the bottling plant, or were present in the original water source (phthalates have been found in some tap water).
Bottled water is regulated for safety, but it's a tricky thing. The EPA regulates tap water, while the FDA oversees bottled. Yet FDA oversight doesn't apply to water packaged and sold within the same state, leaving some 60 to 70 percent of bottled water, including the contents of water cooler jugs, free of FDA regulation, according to the NRDC's report. In this case, testing depends on the states, but the NRDC found that they often don't have adequate resources to oversee bottled water, in some cases lacking even one full-time person for an entire state.
The FDA requires bottlers to regularly test for contaminants, but the agency considers bottled water a low-risk product, so plants may not be inspected every year. According to one FDA official, it's the manufacturer's responsibility to ensure that the product complies with laws and regulations. Some bottlers turn to NSF International, a trade group that conducts yearly-unannounced inspections of plants, looking at the source of the water and the treatment process, and testing for contaminants. Other companies belong to the International Bottled Water Association (IBWA), which also performs annual unannounced tests to ensure the plant is up to FDA standards. IBWA has its own regulations, some of which are stricter than the FDA's.
Bottlers don't have to let consumers know if their product becomes contaminated, but sometimes they pull their products from stores. In fact, between 1990 and 2007, this happened about 100 times, says Peter Gleick of the Pacific Institute in Oakland, California. Among the reasons for recall: contamination with mold, benzene, coliform, and microbes, even crickets.
The Plastic ProblemMost bottled water comes in polyethylene terephthalate bottles, indicated by a number 1, PET or PETE on the bottle's bottom. (No, it's not the same phthalate mentioned earlier.) The bottles are generally safe, says Ken Smith, PhD, immediate past chair of the American Chemical Society's division of environmental chemistry. But scientists say when stored in hot or warm temperatures, the plastic may leach chemicals into the water.
Brenda Decker, 45, of Lake Stockholm, New Jersey, used to buy bottled water in bulk and store it in the crawl space under her house, where it was exposed to high temperatures. But a friend who owns a natural food store recently warned her that the plastic could leach chemicals into the water. So Decker has stopped buying bottled water and is going back to the tap. "It's a process, but I'm willing to go with it to make sure my kid is healthy. That's my biggest drive."
High temperatures in your storage space aren't the only potential risk; so are the other things you keep there. Experts advise against storing water in the garage, near gas fumes, pesticides and other chemicals that could, at the very least, affect the smell and taste of the H2O.
It's not just where you store your water, but what you do with it as you carry it with you. Many people sip from a bottle that's been sitting in a hot car, a potentially dangerous move. "Leaving bottled water out in the car changes the chemical equilibrium so that the materials from the plastic go into the water faster," says Smith.
When 22-year-old Amy Dowley, a senior at Vassar College in Poughkeepsie, New York, heard about these risks, she was worried. "I never drank bottled water, because I knew the water from my tap was clean and healthy, but I used to fill used plastic soda or juice bottles with tap water to carry around," she says. Now she uses a stainless steel Klean Kanteen portable container or fills a cup from the sink. "Any way we can cut back on plastic is a good thing."
"Are there hazards associated with these chemicals?" asks James Kapin, a chemical safety consultant in San Diego. "Absolutely." But as with many debates on chemicals, the exact health risks are unknown. "We very rarely get black-and-white answers for the health effects of long-term exposure. At some point, I hope, there will be a scientific consensus."
In the meantime, experts have raised a warning flag about a few specific chemicals. Antimony is a potentially toxic material used in making PET. Last year, scientists in Germany found that the longer a bottle of water sits around (in a store, in your home), the more antimony it develops. High concentrations of antimony can cause nausea, vomiting and diarrhea. In the study, levels found were below those set as safe by the EPA, but it's a topic that needs more research.
Last summer, a National Institutes of Health (NIH) committee agreed that bisphenol A (BPA), a chemical found in polycarbonate (used to make water cooler jugs, sport-water bottles and other hard plastics, but not PET), may cause neurological and behavioral problems in fetuses, babies and kids. A separate NIH-sponsored panel found that the risk was even greater, saying that adult exposure to BPA likely affects the brain, the female reproductive system and the immune system. The FDA has reviewed these reports and says it will keep monitoring the data to see if the agency needs to take regulatory action.
The Environmental TollThe potential health risks are important to understand, but bottled water also affects the health of the planet.
"Bottled water is an increasingly growing business, and with that comes a whole lot of environmental impact that can be avoided by a turn of the faucet," says Jenny Powers of the NRDC. While we struggle to cut down on our consumption of fossil fuels, bottled water increases them. Virgin petroleum is used to make PET, and the more bottles we use, the more virgin petroleum will be needed to create new bottles. Fossil fuels are burned to fill the bottles and distribute them. (Stephen Kay of IBWA points out that it's not just bottled water, but juices, soda and other beverages packed in plastic that add to this waste.)
Some brands of water come from islands and countries thousands of miles away, and shipping bottles can cause carbon pollution to spill into the water and spew into the air.
Then there's the waste of water itself, says Todd Jarvis, PhD, associate director of the Institute for Water and Watersheds at Oregon State University. According to his calculations, it takes about 72 billion gallons of water a year, worldwide, just to make the empty bottles.
Treating and filtering tap water for bottling creates even more waste. By some estimates, it takes about two liters of water to make every liter you see on store shelves. "Bottled water has a significant environmental burden," says the NRDC's Goldstein.
A big part of the appeal of bottled water is those convenient single-serving bottles. Yet fewer than 20 percent of them ever make it to a second life, according to estimates by the Container Recycling Institute. The rest are tossed onto beaches and roadsides and into landfills, where they could be around for a thousand years. Nestlé Waters, Dasani and other bottlers are trying to be greener, introducing lighter-weight bottles that use up to 30 percent less plastic.
It's a good start, but more needs to be done—by them, and by us.
What You Can DoWorried about the toll your bottled water habit has on you or the earth? Take these steps.
Try the tap again. First, check it out. If your water comes from a public source (rather than a well), you should get a water-quality or consumer-confidence report from the water company once a year. It's also available at any time from the local water utility. Read the report carefully, making sure not only that your water has received a passing grade overall but also that contaminants haven't exceeded the maximum allowable levels, even for a short while. If you have well water, get it tested every year. For more information, call the EPA's toll-free Safe Drinking Water Hotline at 800-426-4791, or visit the website for the Campaign for Safe and Affordable Drinking Water.
Get a canteen. Carry your plain or filtered tap water in a reusable stainless steel or lined drinking container, and clean it between uses. Some come with an easy-to-tote strap. We like the stainless steel versions from Klean Kanteen and New Wave Enviro, and the colorful bottles from SIGG.
Think twice about the office water cooler. If it's made of polycarbonate, it has the potential to leach BPA, a chemical that can cause neurological problems, among other things. And have you ever seen anyone actually clean the water cooler? Probably not.
Shop smart. When you must have bottled, look for brands that have NSF certification or belong to IBWA. Check out the lists at nsf.org or www.bottledwater.org, or look at the bottle itself (the NSF logo appears on labels of tested brands). If the brand you're looking for isn't there, contact the bottler. Ask where the water is bottled and what exactly is in it.
Keep it cool. Don't drink from a bottle that's been subjected to high temperatures (sitting in your car, for example), don't store it anywhere it will be exposed to heat or chemicals, and don't reuse plastic bottles.
Go with glass. Choose glass containers (Eden Springs and Voss are two popular brands) over plastic whenever possible. When you're done, recycle!
Do You Need a Filter?The water that comes out of your faucet is probably safe. In general, toxins in drinking water don't exceed EPA limits, but there are still legitimate concerns. From a funny taste to lead contamination from aging pipes, your tap water may have picked up some unsavory additions along the way. What's in your water? Certain areas of the country are subject to particular toxins, such as runoff from farms and by-products of industry, like arsenic, which can also occur naturally in the environment. Have it tested. If you're concerned, have your water tested by a lab that's certified by the state; the EPA has an online listing of certification officers, or call your health department for recommendations. Choose a filter. Choices range from tabletop containers, such as a carafe with a carbon filter (Brita and PUR are popular brands), to devices that purify the water as it enters your home. In between are faucet-mounted, under-sink and reverse osmosis units. Look for one approved by NSF, Underwriters Laboratories or the Water Quality Association, and clean it as recommended by the manufacturer. Do it yourself. Some water is treated with chlorine to kill bacteria, but the taste turns people off. The fix? Pour water into a clear glass container and leave it uncovered in the refrigerator for 24 hours to let the chlorine dissipate into the air.
Fluoride FactsMost bottled water doesn't contain added fluoride (if it does, it will say so on the label). Kids are drinking more bottled water and less fluoridated tap, and some say that's behind the recent rise in dental decay. While the cavity link hasn't been confirmed, pediatric dentist Mary Hayes, DDS, says, "I tell parents that if they choose bottled water without fluoride, they're losing an opportunity to protect their child's teeth. We know fluoride has a great track record in diminishing the risk of decay."
If your tap water is fortified, you probably don't need fluoride in bottled. But if your family has well water without fluoride, drinks only bottled or uses a filter that removes fluoride (many do), ask your dentist about supplements for your child.
WE DISAGREE!
Read more about Fluoride
Read more about the environmental toll at www.rd.com/bottledwater
Water Filters
Read More About Your Water
Chemicals, contaminants, pollution, price: new reasons to Rethink What you Drink
By Janet Majeski Jemmott
Infinite Health Resources has written plenty about our domestic water supply. I have shared my own amazing discoveries about my drinking water in New York City over the last four years.
Janet Majeski Jemmott gets it right and to the point in what I consider a near perfect hit on our water supply. Although she mostly speaks in terms of drinking water, we all should be just as diligent about our bathing water. We all shower or bathe in the hottest water we can stand. Thereby creating steam. Two things happen. For beginners, our skin absorbs what we put on it, including bath water. The steam we breathe from this bath or shower water contains all the toxins and chemicals found at the tap.Let me share this story.
I installed an Aquasana Water Filter system on my showerhead. My son comes to me days later and says, “Dad, my eyes do not burn like they used to and my skin stopped itching.” I was shocked. I knew he had a weakness to chlorine because in the summer months, pool swimming was a problem for him. I knew chlorine and many other chemicals were in our water. New York City adds chlorine, fluoride and who knows what else to its municipal water supply. The water filter worked. So Filter your water people.
There is however one area in her article I do disagree with. Ms. Jemmott recommends adding fluoride to the daily water diet to supplement the lack of it from drinking filtered water. Fluoride is added to municipal water supplies, due to some oddball study 50 years ago that a town in the South Midwest had a few or no cavities. It was later discovered that fluoride was found in their water supply. So the powers that be decided to add it to every municipal water supply.
On our website, www.infinitehealthresources.com, we have published studies and lawsuits filed by EPA scientists who based on hard evidence disagree with these findings.
Fluoride is chemical byproduct found in the fertilizer manufacturing process. It is a toxic chemical. Period.
Think about this! What about all those millions of people who only have access to well water. There are millions of these people. Are they all walking around toothless or with dentures? Common sense is the basis for this theory.
Here is the link for our published articles on Fluoride
Read on. At the end there will be several links for more information on healthy water and water filters.
Chemicals, contaminants, pollution, price: new reasons to Rethink What you Drink
Growing ThirstRemember the drinking fountain, that once ubiquitous, and free, source of H2O? It seems quaint now. Instead, bottled water is everywhere, in offices, airplanes, stores, homes and restaurants across the country. We consumed over eight billion gallons of the stuff in 2006, a 10 percent increase from 2005. It's refreshing, calorie-free, convenient to carry around, tastier than some tap water and a heck of a lot healthier than sugary sodas. But more and more, people are questioning whether the water, and the package it comes in, is safe, or at least safer than tap water—and if the convenience is worth the environmental impact.
What's in That Bottle?Evocative names and labels depicting pastoral scenes have convinced us that the liquid is the purest drink around. "But no one should think that bottled water is better regulated, better protected or safer than tap," says Eric Goldstein, co-director of the urban program at the Natural Resources Defense Council (NRDC), a nonprofit organization devoted to protecting health and the environment.
Yes, some bottled water comes from sparkling springs and other pristine sources. But more than 25 percent of it comes from a municipal supply. The water is treated, purified and sold to us, often at a thousand fold increases in price. Most people are surprised to learn that they're drinking glorified tap water, but bottlers aren't required to list the source on the label.
This year Aquafina will begin stating on labels that its H2O comes from public water sources. And Nestlé Pure Life bottles will indicate whether the water comes from public, private or deep well sources. Dasani acknowledges on its website, but not on the label itself, that it draws from local water.
Labels can be misleading at best, deceptive at worst. In one notorious case, water coming from a well located near a hazardous waste site was sold to many bottlers. At least one of these companies labeled its product "spring water." In another case, H2O sold as "pure glacier water" came from a public water system in Alaska.
Lisa Ledwidge, 38, of Minneapolis, stopped drinking bottled water a couple of years ago, partly because she found out that many brands come from a municipal supply. "You're spending more per gallon than you would on gasoline for this thing that you can get out of the tap virtually for free," she says. "I wondered, Why am I spending this money while complaining about how much gas costs? But you don't ever hear anyone complain about the price of bottled water." Ledwidge says she now drinks only filtered tap water.
The controversy isn't simply about tap vs. bottled water; most people drink both, knowing the importance of plenty of water. What they may not know is that some bottled water may not be as pure as they expect. In 1999 the NRDC tested more than 1,000 bottles of 103 brands of water. (This is the most recent major report on bottled water safety.) While noting that most bottled water is safe, the organization found that at least one sample of a third of the brands contained bacterial or chemical contaminants, including carcinogens, in levels exceeding state or industry standards. Since the report, no major regulatory changes have been made and bottlers haven't drastically altered their procedures, so the risk is likely still there.
The NRDC found that samples of two brands were contaminated with phthalates, in one case exceeding Environmental Protection Agency (EPA) standards for tap water. These chemicals, used to make plastic softer, are found in cosmetics and fragrances, shower curtains, even baby toys, and are under increasing scrutiny. They're endocrine disrupters, which mean they block or mimic hormones, affecting the body's normal functions. And the effects of exposure to the widespread chemicals may add up.
When exposed to high levels of phthalates during critical developmental periods, male fetuses can have malformed reproductive organs, including undescended testicles. Some experts link phthalates to low sperm counts.
Water bottles do not contain the chemical, which means the phthalates detected by the NRDC probably got into the water during processing at the bottling plant, or were present in the original water source (phthalates have been found in some tap water).
Bottled water is regulated for safety, but it's a tricky thing. The EPA regulates tap water, while the FDA oversees bottled. Yet FDA oversight doesn't apply to water packaged and sold within the same state, leaving some 60 to 70 percent of bottled water, including the contents of water cooler jugs, free of FDA regulation, according to the NRDC's report. In this case, testing depends on the states, but the NRDC found that they often don't have adequate resources to oversee bottled water, in some cases lacking even one full-time person for an entire state.
The FDA requires bottlers to regularly test for contaminants, but the agency considers bottled water a low-risk product, so plants may not be inspected every year. According to one FDA official, it's the manufacturer's responsibility to ensure that the product complies with laws and regulations. Some bottlers turn to NSF International, a trade group that conducts yearly-unannounced inspections of plants, looking at the source of the water and the treatment process, and testing for contaminants. Other companies belong to the International Bottled Water Association (IBWA), which also performs annual unannounced tests to ensure the plant is up to FDA standards. IBWA has its own regulations, some of which are stricter than the FDA's.
Bottlers don't have to let consumers know if their product becomes contaminated, but sometimes they pull their products from stores. In fact, between 1990 and 2007, this happened about 100 times, says Peter Gleick of the Pacific Institute in Oakland, California. Among the reasons for recall: contamination with mold, benzene, coliform, and microbes, even crickets.
The Plastic ProblemMost bottled water comes in polyethylene terephthalate bottles, indicated by a number 1, PET or PETE on the bottle's bottom. (No, it's not the same phthalate mentioned earlier.) The bottles are generally safe, says Ken Smith, PhD, immediate past chair of the American Chemical Society's division of environmental chemistry. But scientists say when stored in hot or warm temperatures, the plastic may leach chemicals into the water.
Brenda Decker, 45, of Lake Stockholm, New Jersey, used to buy bottled water in bulk and store it in the crawl space under her house, where it was exposed to high temperatures. But a friend who owns a natural food store recently warned her that the plastic could leach chemicals into the water. So Decker has stopped buying bottled water and is going back to the tap. "It's a process, but I'm willing to go with it to make sure my kid is healthy. That's my biggest drive."
High temperatures in your storage space aren't the only potential risk; so are the other things you keep there. Experts advise against storing water in the garage, near gas fumes, pesticides and other chemicals that could, at the very least, affect the smell and taste of the H2O.
It's not just where you store your water, but what you do with it as you carry it with you. Many people sip from a bottle that's been sitting in a hot car, a potentially dangerous move. "Leaving bottled water out in the car changes the chemical equilibrium so that the materials from the plastic go into the water faster," says Smith.
When 22-year-old Amy Dowley, a senior at Vassar College in Poughkeepsie, New York, heard about these risks, she was worried. "I never drank bottled water, because I knew the water from my tap was clean and healthy, but I used to fill used plastic soda or juice bottles with tap water to carry around," she says. Now she uses a stainless steel Klean Kanteen portable container or fills a cup from the sink. "Any way we can cut back on plastic is a good thing."
"Are there hazards associated with these chemicals?" asks James Kapin, a chemical safety consultant in San Diego. "Absolutely." But as with many debates on chemicals, the exact health risks are unknown. "We very rarely get black-and-white answers for the health effects of long-term exposure. At some point, I hope, there will be a scientific consensus."
In the meantime, experts have raised a warning flag about a few specific chemicals. Antimony is a potentially toxic material used in making PET. Last year, scientists in Germany found that the longer a bottle of water sits around (in a store, in your home), the more antimony it develops. High concentrations of antimony can cause nausea, vomiting and diarrhea. In the study, levels found were below those set as safe by the EPA, but it's a topic that needs more research.
Last summer, a National Institutes of Health (NIH) committee agreed that bisphenol A (BPA), a chemical found in polycarbonate (used to make water cooler jugs, sport-water bottles and other hard plastics, but not PET), may cause neurological and behavioral problems in fetuses, babies and kids. A separate NIH-sponsored panel found that the risk was even greater, saying that adult exposure to BPA likely affects the brain, the female reproductive system and the immune system. The FDA has reviewed these reports and says it will keep monitoring the data to see if the agency needs to take regulatory action.
The Environmental TollThe potential health risks are important to understand, but bottled water also affects the health of the planet.
"Bottled water is an increasingly growing business, and with that comes a whole lot of environmental impact that can be avoided by a turn of the faucet," says Jenny Powers of the NRDC. While we struggle to cut down on our consumption of fossil fuels, bottled water increases them. Virgin petroleum is used to make PET, and the more bottles we use, the more virgin petroleum will be needed to create new bottles. Fossil fuels are burned to fill the bottles and distribute them. (Stephen Kay of IBWA points out that it's not just bottled water, but juices, soda and other beverages packed in plastic that add to this waste.)
Some brands of water come from islands and countries thousands of miles away, and shipping bottles can cause carbon pollution to spill into the water and spew into the air.
Then there's the waste of water itself, says Todd Jarvis, PhD, associate director of the Institute for Water and Watersheds at Oregon State University. According to his calculations, it takes about 72 billion gallons of water a year, worldwide, just to make the empty bottles.
Treating and filtering tap water for bottling creates even more waste. By some estimates, it takes about two liters of water to make every liter you see on store shelves. "Bottled water has a significant environmental burden," says the NRDC's Goldstein.
A big part of the appeal of bottled water is those convenient single-serving bottles. Yet fewer than 20 percent of them ever make it to a second life, according to estimates by the Container Recycling Institute. The rest are tossed onto beaches and roadsides and into landfills, where they could be around for a thousand years. Nestlé Waters, Dasani and other bottlers are trying to be greener, introducing lighter-weight bottles that use up to 30 percent less plastic.
It's a good start, but more needs to be done—by them, and by us.
What You Can DoWorried about the toll your bottled water habit has on you or the earth? Take these steps.
Try the tap again. First, check it out. If your water comes from a public source (rather than a well), you should get a water-quality or consumer-confidence report from the water company once a year. It's also available at any time from the local water utility. Read the report carefully, making sure not only that your water has received a passing grade overall but also that contaminants haven't exceeded the maximum allowable levels, even for a short while. If you have well water, get it tested every year. For more information, call the EPA's toll-free Safe Drinking Water Hotline at 800-426-4791, or visit the website for the Campaign for Safe and Affordable Drinking Water.
Get a canteen. Carry your plain or filtered tap water in a reusable stainless steel or lined drinking container, and clean it between uses. Some come with an easy-to-tote strap. We like the stainless steel versions from Klean Kanteen and New Wave Enviro, and the colorful bottles from SIGG.
Think twice about the office water cooler. If it's made of polycarbonate, it has the potential to leach BPA, a chemical that can cause neurological problems, among other things. And have you ever seen anyone actually clean the water cooler? Probably not.
Shop smart. When you must have bottled, look for brands that have NSF certification or belong to IBWA. Check out the lists at nsf.org or www.bottledwater.org, or look at the bottle itself (the NSF logo appears on labels of tested brands). If the brand you're looking for isn't there, contact the bottler. Ask where the water is bottled and what exactly is in it.
Keep it cool. Don't drink from a bottle that's been subjected to high temperatures (sitting in your car, for example), don't store it anywhere it will be exposed to heat or chemicals, and don't reuse plastic bottles.
Go with glass. Choose glass containers (Eden Springs and Voss are two popular brands) over plastic whenever possible. When you're done, recycle!
Do You Need a Filter?The water that comes out of your faucet is probably safe. In general, toxins in drinking water don't exceed EPA limits, but there are still legitimate concerns. From a funny taste to lead contamination from aging pipes, your tap water may have picked up some unsavory additions along the way. What's in your water? Certain areas of the country are subject to particular toxins, such as runoff from farms and by-products of industry, like arsenic, which can also occur naturally in the environment. Have it tested. If you're concerned, have your water tested by a lab that's certified by the state; the EPA has an online listing of certification officers, or call your health department for recommendations. Choose a filter. Choices range from tabletop containers, such as a carafe with a carbon filter (Brita and PUR are popular brands), to devices that purify the water as it enters your home. In between are faucet-mounted, under-sink and reverse osmosis units. Look for one approved by NSF, Underwriters Laboratories or the Water Quality Association, and clean it as recommended by the manufacturer. Do it yourself. Some water is treated with chlorine to kill bacteria, but the taste turns people off. The fix? Pour water into a clear glass container and leave it uncovered in the refrigerator for 24 hours to let the chlorine dissipate into the air.
Fluoride FactsMost bottled water doesn't contain added fluoride (if it does, it will say so on the label). Kids are drinking more bottled water and less fluoridated tap, and some say that's behind the recent rise in dental decay. While the cavity link hasn't been confirmed, pediatric dentist Mary Hayes, DDS, says, "I tell parents that if they choose bottled water without fluoride, they're losing an opportunity to protect their child's teeth. We know fluoride has a great track record in diminishing the risk of decay."
If your tap water is fortified, you probably don't need fluoride in bottled. But if your family has well water without fluoride, drinks only bottled or uses a filter that removes fluoride (many do), ask your dentist about supplements for your child.
WE DISAGREE!
Read more about Fluoride
Read more about the environmental toll at www.rd.com/bottledwater
Water Filters
Read More About Your Water
Sunday, February 3, 2008
Fifth Disease & Parvovirus B19 Infection
Fifth Disease & Parvovirus B19 Infection
We recently received an emergency notification that some children have come down with Fifth Disease & Parvovirus B19 Infection. I was completely lost on this one, so I have decided to share what Fifth Disease & Parvovirus B19 Infection is with as many people as possible.
What is “fifth disease?”
Fifth disease is a mild rash illness that occurs most commonly in children. The ill child typically has a “slapped cheek” rash on the face and a lacy red rash on the trunk and limbs. Occasionally, the rash may itch. An ill child may have a low-grade fever, malaise, or a “cold” a few days before the rash breaks out. The child usually not very ill, and the rash resolve in 7 to 10 days.
What causes fifth disease?
Fifth disease is caused by infection with human parvovirus B19. This virus infects only humans. Pet dogs or cats may be immunized against “parvovirus,” but these are animal parvoviruses that do not infect humans. Therefore, a child cannot “catch” parvovirus from a pet dog or cat, and a pet cat or dog cannot catch human parvovirus B19 from an ill child.
Can adults get fifth disease?
Yes, they can. An adult who is not immune can be infected with parvovirus B19 and either have no symptoms or develop the typical rash of fifth disease, joint pain or swelling, or both. Usually, joints on both sides of the body are affected. The joints most frequently affected are the hands, wrists and knees. The joint pain swelling usually resolve in a week or two, but they may last several months. About 50% of adults, however, have been previously infected with parvovirus B19, have developed immunity to the virus, and cannot get fifth disease.
Is fifth disease contagious?
Yes. A person infected with parvovirus B19 is contagious during the early part of the illness, before the rash appears. By the time a child has the characteristic “slapped cheek” rash of fifth disease, for example, he or she is probably no longer contagious and may return to school or childcare center. This contagious period is different than that for many other rash illnesses, such as measles, for which the child is contagious while he or she has the rash.
How does someone get infected with parvovirus B19?
Parvovirus B19 has been found in the respiratory secretions (e.g. saliva, sputum, or nasal mucus) of infected persons before onset of rash, when they appear to “just have a cold.” The virus is probably spread from person to person by direct contact with those secretions, such as sharing drinking cups or utensils. In a household, as many as 50% of the susceptible persons exposed to a family member who has fifth disease may become infected. During school outbreaks, 10% to 60% of the students may get fifth disease.
How soon after infection with parvovirus B19 does a person become ill?
A susceptible person usually becomes ill 4 to 14 days after being infected with the virus, but may become ill for as long as 20 days after the infection.
Does everyone who is infected with parvovirus B19 become ill?
No. During outbreaks of fifth disease, about 20% of adults and children who are infected with parvovirus B19 do not develop any symptoms. Furthermore, other persons infected with the virus will have a non-specific illness that does not have characteristics or fifth disease. Persons infected with the virus, however, do develop lasting immunity that protects them against infection in the future.
How is fifth disease diagnosed?
A physician can often diagnose fifth disease by seeing the typical rash during a physical examination. In cases in which it is important to confirm diagnosis, a blood test may be done to look for antibodies to parvovirus. Antibodies are proteins produced by the immune system in response to parvovirus B19 and other germs. If immunoglobulin M (IgM) antibody to parvovirus B19 is detected, the test result suggests that the person has had recent infection.
Is fifth disease serious?Fifth disease is usually a mild illness that resolves on its own among children and adults who are otherwise healthy. Joint pain and swelling in adults usually resolve without long-term disability.
Parvovirus B19 infection may cause a serious illness in persons with sickle-cell disease or similar types of chronic anemia. In such persons, parvovirus B19 can cause n acute, severe anemia. The ill person may be pale, weak and tired and should see his or her physician for treatment. (The typical rash of fifth disease is rarely seen in these persons.) One the infection is controlled, the anemia resolves. Furthermore, persons who have problems with their immune systems may also develop a chronic anemia with parvovirus B19 infection that requires medical treatment. People who have leukemia or cancer, who were born with immune deficiencies, who have received an organ transplant, or have human immunodeficiency virus (HIV) infection are at rise for serious illness due to parvovirus B19 infection.
Occasionally, serious complications may develop from parvovirus B19 infection during pregnancy. For details see the CDC information sheet entitled, “Parvovirus B19 Infection and Pregnancy.”
How are parvovirus B19 infections treated?
Treatment of symptoms such as fever, pain, or itching is usually all that it needed for fifth disease. Adults with joint pain and swelling may need to rest, restrict their activities, and take medicines such as aspirin or ibuprofen to relieve symptoms. The few people who have anemia caused by parvovirus B19 infection may need to be hospitalized and receive blood transfusions. Persons with immune problems may need special medical care, including treatment with immune globulin (antibodies), to help their bodies get rid of infection.
Can parvovirus B19 infection be prevented?
There is no vaccine or medicine that prevent parvovirus B19infection. Frequent hand washing is recommended as a practical and probably effective method to decrease the chance of becoming infected. Excluding persons with fifth disease from work, child care center or schools is not likely to prevent the spread of the virus, since people are contagious before they develop the rash.
For further information, contact the Respiratory and Enertic Viruses Branch, National Center for Infectious Diseases, at 404-639-3607 (telephone) or 404-639-4960 (facsimile)
Visit www.infinitehealthresources.com for more on healthy living.
We recently received an emergency notification that some children have come down with Fifth Disease & Parvovirus B19 Infection. I was completely lost on this one, so I have decided to share what Fifth Disease & Parvovirus B19 Infection is with as many people as possible.
What is “fifth disease?”
Fifth disease is a mild rash illness that occurs most commonly in children. The ill child typically has a “slapped cheek” rash on the face and a lacy red rash on the trunk and limbs. Occasionally, the rash may itch. An ill child may have a low-grade fever, malaise, or a “cold” a few days before the rash breaks out. The child usually not very ill, and the rash resolve in 7 to 10 days.
What causes fifth disease?
Fifth disease is caused by infection with human parvovirus B19. This virus infects only humans. Pet dogs or cats may be immunized against “parvovirus,” but these are animal parvoviruses that do not infect humans. Therefore, a child cannot “catch” parvovirus from a pet dog or cat, and a pet cat or dog cannot catch human parvovirus B19 from an ill child.
Can adults get fifth disease?
Yes, they can. An adult who is not immune can be infected with parvovirus B19 and either have no symptoms or develop the typical rash of fifth disease, joint pain or swelling, or both. Usually, joints on both sides of the body are affected. The joints most frequently affected are the hands, wrists and knees. The joint pain swelling usually resolve in a week or two, but they may last several months. About 50% of adults, however, have been previously infected with parvovirus B19, have developed immunity to the virus, and cannot get fifth disease.
Is fifth disease contagious?
Yes. A person infected with parvovirus B19 is contagious during the early part of the illness, before the rash appears. By the time a child has the characteristic “slapped cheek” rash of fifth disease, for example, he or she is probably no longer contagious and may return to school or childcare center. This contagious period is different than that for many other rash illnesses, such as measles, for which the child is contagious while he or she has the rash.
How does someone get infected with parvovirus B19?
Parvovirus B19 has been found in the respiratory secretions (e.g. saliva, sputum, or nasal mucus) of infected persons before onset of rash, when they appear to “just have a cold.” The virus is probably spread from person to person by direct contact with those secretions, such as sharing drinking cups or utensils. In a household, as many as 50% of the susceptible persons exposed to a family member who has fifth disease may become infected. During school outbreaks, 10% to 60% of the students may get fifth disease.
How soon after infection with parvovirus B19 does a person become ill?
A susceptible person usually becomes ill 4 to 14 days after being infected with the virus, but may become ill for as long as 20 days after the infection.
Does everyone who is infected with parvovirus B19 become ill?
No. During outbreaks of fifth disease, about 20% of adults and children who are infected with parvovirus B19 do not develop any symptoms. Furthermore, other persons infected with the virus will have a non-specific illness that does not have characteristics or fifth disease. Persons infected with the virus, however, do develop lasting immunity that protects them against infection in the future.
How is fifth disease diagnosed?
A physician can often diagnose fifth disease by seeing the typical rash during a physical examination. In cases in which it is important to confirm diagnosis, a blood test may be done to look for antibodies to parvovirus. Antibodies are proteins produced by the immune system in response to parvovirus B19 and other germs. If immunoglobulin M (IgM) antibody to parvovirus B19 is detected, the test result suggests that the person has had recent infection.
Is fifth disease serious?Fifth disease is usually a mild illness that resolves on its own among children and adults who are otherwise healthy. Joint pain and swelling in adults usually resolve without long-term disability.
Parvovirus B19 infection may cause a serious illness in persons with sickle-cell disease or similar types of chronic anemia. In such persons, parvovirus B19 can cause n acute, severe anemia. The ill person may be pale, weak and tired and should see his or her physician for treatment. (The typical rash of fifth disease is rarely seen in these persons.) One the infection is controlled, the anemia resolves. Furthermore, persons who have problems with their immune systems may also develop a chronic anemia with parvovirus B19 infection that requires medical treatment. People who have leukemia or cancer, who were born with immune deficiencies, who have received an organ transplant, or have human immunodeficiency virus (HIV) infection are at rise for serious illness due to parvovirus B19 infection.
Occasionally, serious complications may develop from parvovirus B19 infection during pregnancy. For details see the CDC information sheet entitled, “Parvovirus B19 Infection and Pregnancy.”
How are parvovirus B19 infections treated?
Treatment of symptoms such as fever, pain, or itching is usually all that it needed for fifth disease. Adults with joint pain and swelling may need to rest, restrict their activities, and take medicines such as aspirin or ibuprofen to relieve symptoms. The few people who have anemia caused by parvovirus B19 infection may need to be hospitalized and receive blood transfusions. Persons with immune problems may need special medical care, including treatment with immune globulin (antibodies), to help their bodies get rid of infection.
Can parvovirus B19 infection be prevented?
There is no vaccine or medicine that prevent parvovirus B19infection. Frequent hand washing is recommended as a practical and probably effective method to decrease the chance of becoming infected. Excluding persons with fifth disease from work, child care center or schools is not likely to prevent the spread of the virus, since people are contagious before they develop the rash.
For further information, contact the Respiratory and Enertic Viruses Branch, National Center for Infectious Diseases, at 404-639-3607 (telephone) or 404-639-4960 (facsimile)
Visit www.infinitehealthresources.com for more on healthy living.
Subscribe to:
Posts (Atom)