New research in human participants explores a novel intervention that aims to weaken traumatic memories and lessen their psychological impact.
Saturday, March 23, 2019
Medical News Today: Could prescription vegetables be the future of healthcare?
A recent study investigates whether prescribing healthful food could, in time, save money and improve health. The results are surprising.
Friday, March 22, 2019
Bevin says he exposed his nine children to chickenpox, pooh-poohs required vaccinations, misstates who requires them
By Melissa Patrick
Kentucky Health News
Gov. Matt Bevin said in a radio interview that he exposed his nine children to chickenpox instead of vaccinating them, a practice that is strongly opposed by health officials as risky.
Bevin also cast doubt on longstanding government policy of requiring vaccinations, and incorrectly attributed the requirement to the federal government rather than the state. His administration recently made it easier for parents to exempt their children from school vaccination requirements.
Bevin raised the topic on Bowling Green's WKCT, where the hosts had been discussing a lawsuiit by a Northern Kentucky teenager who had been barred from playing basketball, and then from school entirely, because he had not been vaccinated for chickenpox. Host Chad Young asked Bevin about bills he might veto, but the governor said he first wanted to continue the chickenpox discussion.
“Every single one of my kids had the chickenpox," Bevin said. "They got the chickenpox on purpose because we found a neighbor that had it and I went and made sure every one of my kids was exposed to it, and they got it. . . . They were miserable for a few days, and they all turned out fine.”
Bevin and his wife, Glenna, have nine children, ages 5 to 16, according to his campaign website.
The U.S. Centers for Disease Control and Prevention strongly discourages such "chickenpox parties," saying they are not worth the risk.
"Chickenpox can be serious and can lead to severe complications and death, even in healthy children," the agency warns on its website. "There is no way to tell in advance how severe your child’s symptoms will be. So it is not worth taking the chance of exposing your child to someone with the disease. The best way to protect infants and children against chickenpox is to get them vaccinated."
Dr Sean McTigue, a pediatric infectious-disease specialist at the University of Kentucky, told Kentucky Health News, said the efficacy and safety of vaccines has been proven "time and time again."
McTigue, who teaches pediatrics, said "chickenpox parties" might have made sense before there was a vaccine against the disease, because its risks after infancy increase with age, and some parents wanted to make sure they got it while they were young. But in the post-vaccine era, he called such parties "ludicrous." The vaccine for chickenpox was licensed for use in the U.S. in 1995.
Before that, the CDC reports, about 4 million Americans got chickenpox each year, over 10,500 were hospitalized and about 100 to 150 died.
Chickenpox is a highly contagious infection caused by the varicella-zoster virus that causes itchy, blister-like rash. Most children who get chickenpox recover completely, as the governor's children did, but the CDC says it can be "serious, even deadly, especially for babies, adolescents, adults, pregnant women, and people with a weakened immune system."
McTigue pointed out that a person who has had a natural chickenpox infection is at a greater risk than a vaccinated person of getting shingles, a painful skin rash that is caused by the same virus that causes chickenpox.
During the radio interview, Bevin said that vaccinating children should be a parent's decision, not the government's.
"If you are worried about your child getting chickenpox or whatever else, vaccinate your child. . . . But for some people, and for some parents, for some reason they choose otherwise," he said. "This is America. The federal government should not be forcing this upon people."
The federal government does not force states to require vaccinations, only recommends that they do, a CDC spokesperson said. The National Conference of State Legislatures says all 50 states have laws requiring specific vaccines for students; 47 grant religious exemptions and 18 allow philosophical exemptions.
Kentucky only allows medical and religious exemptions. Chickenpox is among the diseases for which the state requires proof of vaccination, or medical documentation that the child has had the disease, in order to enter public kindergarten.
In 2017 the Bevin administration made it easier for parents to invoke the religious exemption, allowing to the law requiring vaccination to attend school. The new rules allow parents to download a form, have it notarized and submit it to their school upon enrollment, instead of having to get a signed form from a health-care provider. Spectrum News reported that the number of Kentucky parents claiming the religious exemption increased 59 percent in the 2017-18 school year.
A representative of the state Cabinet for Health and Family Services told a legislative committee in 2017 that the changes had been in the works for several years, in response to complaints that a medical entity should not have authority over a religious exemption; that a co-payment was often required to get a provider's signature; and that parents and guardians were having trouble finding providers to sign the forms.
'Herd immunity' requires mandatory vaccinations
Bevin's assertion that governments shouldn't require vaccinations doesn't take into account the importance of "herd immunity," which results when enough people have been immunized against a disease to protect others who are not immunized. Some are not immunized because their immune systems are too weak to allow them to be vaccinated, or because they are too young to be vaccinated.
People with weakened immune systems include those with cancer, especially if they are being treated with an aggressive chemotherapy, people who have had bone-marrow transplants, people who have had an organ transplant, people with auto-immune disorders, like rheumatoid arthritis or Lupus, or people with acquired immunodeficiency syndrome, or AIDS.
"Those people are absolutely reliant upon herd immunity because we can't immunize them," McTigue said. "The only way that we have to protect them is to ensure that everybody around them is immunized so that the chances of them actually coming into contact with somebody who has one of these very infectious viruses or bacteria is very, very low."
He said herd immunity is vitally important to protect babies, because they can't be vaccinated for measles, mumps and rubella or chickenpox until they are a year old because these vaccines are made with very weak, but live viruses.
"So, every single baby less than one year old is unvaccinated and unprotected against those conditions," he said. "And the young babies who cannot yet be immunized against those conditions are exactly the patients that we worry about the most if they get those infections because they are at greatest risk of complications." He added, "A varicella infection to a newborn baby can be fatal."
It should also be noted that parents who chose to not get their children vaccinated also depend on herd immunity to keep their children healthy. But the practice puts others at risk, McTigue said.
"Not only does it put your child at risk of getting severe and potentially life-threatening illnesses, but it also puts other people in the community at risk of getting serious and potentially life-threatening infections," he said.
The case that set the stage
After a chickenpox outbreak at Assumption Academy, a Roman Catholic school in Boone County, the Northern Kentucky Health Department on March 14 told students without proof of vaccination or immunity against chickenpox to not attend school until further notice, and their extracurricular activities were canceled.
Jerome Kunkel, an 18-year-old senior at the high school who has not been been vaccinated, filed suit against the department, claiming "health officials violated his freedom of religion and other rights by ordering students without the vaccine to not attend school or extracurricular activities," Max Londberg reports for the Cincinnati Enquirer. The suit says Kunkel opposes the vaccine on religious grounds "due to its being derived from aborted fetal cells."
The vaccine was developed in the 1960s with cells from a legally aborted fetus, but no aborted fetuses being used today, McTigue said. He said the Roman Catholic Church supports the vaccine.
In response to Bevin's comments, the Kentucky Democratic Party called on the governor to clarify his position on vaccination against the hepatitis A virus, which has killed 44 people in the state.
“Kentucky is currently experiencing the worst outbreak of hepatitis A in the country. It is a major public health risk at this point. The last thing we need is Governor Bevin suggesting that immunization is not important," the party said on its website. "Governor Bevin should reassure the public that he supports the recommendation of the entire medical community with respect to controlling an outbreak of Hepatitis A, which is immunization.”
The governor's office did not return a request for further comment. Bevin is running for re-election this year; his running mate is state Sen. Ralph Alvarado, a Winchester physician who has publicly endorsed vaccinations.
Kentucky Health News
Gov. Matt Bevin said in a radio interview that he exposed his nine children to chickenpox instead of vaccinating them, a practice that is strongly opposed by health officials as risky.
Bevin also cast doubt on longstanding government policy of requiring vaccinations, and incorrectly attributed the requirement to the federal government rather than the state. His administration recently made it easier for parents to exempt their children from school vaccination requirements.
Bevin raised the topic on Bowling Green's WKCT, where the hosts had been discussing a lawsuiit by a Northern Kentucky teenager who had been barred from playing basketball, and then from school entirely, because he had not been vaccinated for chickenpox. Host Chad Young asked Bevin about bills he might veto, but the governor said he first wanted to continue the chickenpox discussion.
 |
| Gov. Matt Bevin |
Bevin and his wife, Glenna, have nine children, ages 5 to 16, according to his campaign website.
The U.S. Centers for Disease Control and Prevention strongly discourages such "chickenpox parties," saying they are not worth the risk.
"Chickenpox can be serious and can lead to severe complications and death, even in healthy children," the agency warns on its website. "There is no way to tell in advance how severe your child’s symptoms will be. So it is not worth taking the chance of exposing your child to someone with the disease. The best way to protect infants and children against chickenpox is to get them vaccinated."
Dr Sean McTigue, a pediatric infectious-disease specialist at the University of Kentucky, told Kentucky Health News, said the efficacy and safety of vaccines has been proven "time and time again."
 |
| Centers for Disease Control and Prevention graphic For a larger version, click on it. |
Chickenpox is a highly contagious infection caused by the varicella-zoster virus that causes itchy, blister-like rash. Most children who get chickenpox recover completely, as the governor's children did, but the CDC says it can be "serious, even deadly, especially for babies, adolescents, adults, pregnant women, and people with a weakened immune system."
McTigue pointed out that a person who has had a natural chickenpox infection is at a greater risk than a vaccinated person of getting shingles, a painful skin rash that is caused by the same virus that causes chickenpox.
During the radio interview, Bevin said that vaccinating children should be a parent's decision, not the government's.
"If you are worried about your child getting chickenpox or whatever else, vaccinate your child. . . . But for some people, and for some parents, for some reason they choose otherwise," he said. "This is America. The federal government should not be forcing this upon people."
The federal government does not force states to require vaccinations, only recommends that they do, a CDC spokesperson said. The National Conference of State Legislatures says all 50 states have laws requiring specific vaccines for students; 47 grant religious exemptions and 18 allow philosophical exemptions.
In 2017 the Bevin administration made it easier for parents to invoke the religious exemption, allowing to the law requiring vaccination to attend school. The new rules allow parents to download a form, have it notarized and submit it to their school upon enrollment, instead of having to get a signed form from a health-care provider. Spectrum News reported that the number of Kentucky parents claiming the religious exemption increased 59 percent in the 2017-18 school year.
A representative of the state Cabinet for Health and Family Services told a legislative committee in 2017 that the changes had been in the works for several years, in response to complaints that a medical entity should not have authority over a religious exemption; that a co-payment was often required to get a provider's signature; and that parents and guardians were having trouble finding providers to sign the forms.
'Herd immunity' requires mandatory vaccinations
Bevin's assertion that governments shouldn't require vaccinations doesn't take into account the importance of "herd immunity," which results when enough people have been immunized against a disease to protect others who are not immunized. Some are not immunized because their immune systems are too weak to allow them to be vaccinated, or because they are too young to be vaccinated.
People with weakened immune systems include those with cancer, especially if they are being treated with an aggressive chemotherapy, people who have had bone-marrow transplants, people who have had an organ transplant, people with auto-immune disorders, like rheumatoid arthritis or Lupus, or people with acquired immunodeficiency syndrome, or AIDS.
"Those people are absolutely reliant upon herd immunity because we can't immunize them," McTigue said. "The only way that we have to protect them is to ensure that everybody around them is immunized so that the chances of them actually coming into contact with somebody who has one of these very infectious viruses or bacteria is very, very low."
He said herd immunity is vitally important to protect babies, because they can't be vaccinated for measles, mumps and rubella or chickenpox until they are a year old because these vaccines are made with very weak, but live viruses.
"So, every single baby less than one year old is unvaccinated and unprotected against those conditions," he said. "And the young babies who cannot yet be immunized against those conditions are exactly the patients that we worry about the most if they get those infections because they are at greatest risk of complications." He added, "A varicella infection to a newborn baby can be fatal."
It should also be noted that parents who chose to not get their children vaccinated also depend on herd immunity to keep their children healthy. But the practice puts others at risk, McTigue said.
"Not only does it put your child at risk of getting severe and potentially life-threatening illnesses, but it also puts other people in the community at risk of getting serious and potentially life-threatening infections," he said.
The case that set the stage
After a chickenpox outbreak at Assumption Academy, a Roman Catholic school in Boone County, the Northern Kentucky Health Department on March 14 told students without proof of vaccination or immunity against chickenpox to not attend school until further notice, and their extracurricular activities were canceled.
Jerome Kunkel, an 18-year-old senior at the high school who has not been been vaccinated, filed suit against the department, claiming "health officials violated his freedom of religion and other rights by ordering students without the vaccine to not attend school or extracurricular activities," Max Londberg reports for the Cincinnati Enquirer. The suit says Kunkel opposes the vaccine on religious grounds "due to its being derived from aborted fetal cells."
The vaccine was developed in the 1960s with cells from a legally aborted fetus, but no aborted fetuses being used today, McTigue said. He said the Roman Catholic Church supports the vaccine.
In response to Bevin's comments, the Kentucky Democratic Party called on the governor to clarify his position on vaccination against the hepatitis A virus, which has killed 44 people in the state.
“Kentucky is currently experiencing the worst outbreak of hepatitis A in the country. It is a major public health risk at this point. The last thing we need is Governor Bevin suggesting that immunization is not important," the party said on its website. "Governor Bevin should reassure the public that he supports the recommendation of the entire medical community with respect to controlling an outbreak of Hepatitis A, which is immunization.”
The governor's office did not return a request for further comment. Bevin is running for re-election this year; his running mate is state Sen. Ralph Alvarado, a Winchester physician who has publicly endorsed vaccinations.
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Doctor pleads guilty to illegal prescription of painkillers, some of which resulted in two deaths, federal prosecutors say
A doctor in Appalachian Southern Kentucky pleaded guilty March 18 to 13 counts of prescribing controlled substances without any legitimate medical purpose and outside the course of professional medical practice, the U.S. attorney for the Western District of Kentucky announced March 22.
Dr. Michael L. Cummings, 63, a family practitioner in Albany,faces a maximum prison term of 145 years, a combined maximum fine of $7.25 million, and three years of supervised release. Sentencing is scheduled for June 19 before District Court Chief Judge Greg Stivers.
Cummings' plea agreement says that in 2012-14, he prescribed the painkillers Oxycodone, OxyContin, Endocet and hydrocodone, the anti-anxiety medicines Valium and alprazolam, the appetite suppressant phentermine, and the sleep aid zolpidem tartrate, all "without any legitimate medical purpose and outside the course of professional medical practice."
Two years ago, Cummings was charged with 18 counts of illegal prescriptions "resulting in the deaths of three patients" in 2014, the U.S. attorney's office said at the time. The news releases used initials to identify the decedents; one of those named in the 2014 release was not named in the latest one. The case was investigated by the FBI and state police, the attorney's office said.
Youth suicide rates are increasing in Ky.; Courier Journal does in-depth stories, in hopes of spurring conversation to find out why
 |
| The editor of the Louisville Courier Journal posted this note with the package of stories, |
In a package of stories, Allison Ross of the Louisville Courier Journal reports on the rising number of youth suicide deaths over the past five years in Kentucky. She tells the tales of four Kentucky youth who died by suicide, and explores the causes and challenges that youth suicide presents.
One of the stories is about Marcus Pryor, a 12-year-old whose mother, Sandy Metzmeier, said he took a full bottle of antidepressant pills because a friend was being mean to him.
Metzmeier, from Flaherty in Meade County, told Ross that her son called for help from his bedroom and she rushed him to the hospital, where he was treated and sent home, but later he began to have seizures and died the next morning. he was one of 10 Kentucky children under the age of 15 to die of suicide in 2017, Ross reports.
Metzmeier said Marcus told her that he didn't want to die: "He did something drastic and stupid to get attention and thought Mommy would fix it."
Kentucky suicide deaths among those who 18 and younger nearly doubled in 2015, to a total of 34, compared to only 18 in 2014. The numbers kept going up and remained high, Ross notes: "In 2016, 36 killed themselves. In 2017, there were 36 more. At least 10 were not yet old enough to drive. And in 2018, preliminary records show 31 children and teens in Kentucky took their own lives. That same year, more Kentucky children and teens died of suicide than by homicide."
Ross reports that Jefferson County has already seen four youth suicides in the first three months of 2019. "If children were dying of the flu like this, it would be in the paper every day," Sara Oliver of Louisville, who lost her 16-year-old daughter to suicide in 2017, told Ross.
Oliver said she thought her daughter's first iPhone was the start of her anxiety, noting that she was "unable to detach herself from her phone and probably had a warped impression of success," even though she was on her school's homecoming court, sang in Ballard High School's madrigal choir, and played lacrosse.
Experts, advocates and families call for more research and resources to prevent youth suicide.
"Doctors say youth and teens don't have enough access to behavioral health services," Ross writes. "Advocates say there's not enough money going to intervention programs such as suicide hotlines, where desperate people must sometimes be put in a queue until they can talk to a counselor. And researchers say they need more grants to better research how influences such as social media and bullying play a role in why some children kill themselves and others do not."
Patti Clark, who oversees substance abuse and suicide prevention programs for the Cabinet for Health and Family Services, told Ross that some of the increase in youth suicide numbers may be attributed to better reporting, because the state has worked to educate county coroners about properly labeling a suicide. But she added that this doesn't entirely explain the uptick.
Clark told Ross that she was particularly concerned about surveys showing increased suicidal thoughts and actions by younger children, a national trend that include Kentucky.
"In the past decade, the U.S. suicide rate for children and teens 18 and younger has grown by more than 90 percent — with 2017 suicide deaths in this age group hitting the highest count since data collection began in 1999," Ross writes, citing the Centers for Disease Control and Prevention.
Jefferson County Coroner Barbara Weakley-Jones told Ross that her office saw nine youth suicides last year and has already had four in the first quarter of this year, with some of them very young: "You didn't use to see a 6- or 9-year-old commit suicide."
In response to the increase in youth suicides, Jefferson County Public Schools held its first "Bullying and Suicide Prevention Summit" March 21 for school counselors, principals and administrators to talk about prevention and response strategies, Liz Schlemmer reports for WFPL.
Researchers say that youth suicide is rarely caused by a single factor and that they "have noted that some trends, such as bullying and suicide-related behavior, are closely related and that access to firearms has also been linked to a greater chance of suicide," Ross reports.
The CDC and other organizations note that suicide is not solely a mental health concern and that many people who kill themselves had no previous known mental health conditions.
And experts say that, despite efforts, there are still not enough resources for mental-health and crisis help. Ross writes that other issues include stagnant Medicaid reimbursements and an unfunded mandates to provide suicide prevention training in schools, with no oversight over the types of programming presented.
In telling the story of Alechia Click and her ex-husband Ron Click's son, Ronnie, who was 17 when he killed himself in October, Ross reports on the many unanswered questions that Alechia deals with in her loss, like "Was there anything I could have done?" Ron told Ross that there were no warning signs that his son was considering killing himself.
"I told him I loved the shit out of him, and I was proud of him," he said, his voice cracking. "It still didn't help."
Courier Journal Editor Richard Green, in a special note attached to the story, says the paper chose to write about these individual suicides in "hopes a larger community-wide conversation begins about why death by suicide is happening far too frequently among our youth."
Warning signs that may indicate risk of suicide include:
- Talking about wanting to die or interest in killing oneself
- Looking for a way to kill themselves, like searching online or buying a gun
- Talking about feeling hopeless or having no reason to live
- Talking about feeling trapped or feeling unbearable pain
- Talking about being a burden to others
- Increased use of alcohol or drugs
- Acting anxious or agitated; behaving recklessly
- Sleeping too little or too much
- Withdrawing or isolating oneself
- Showing rage or talking about seeking revenge
- Extreme mood swings
