In the meantime let's hope the CIA is not testing multi drug resistant TB in the NYC subways?
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Legislature Approves Bill Allowing Pharmacists to Give Meningitis Vaccination
By ANEMONA HARTOCOLLIS
Published: June 23, 2013
The State Legislature has passed a bill permitting pharmacists to give meningitis vaccinations, a measure aimed at a deadly outbreak among gay and bisexual men in New York City.
The bill, which lawmakers approved Thursday, would add the meningitis vaccination to a short list of vaccinations that pharmacists in the state may administer. Others include vaccinations for the flu, pneumonia and acute herpes zoster.
A new strain of bacterial meningitis has been infecting gay and bisexual
men in recent years. Its fatality rate — one in three people, compared
with the one in five who succumb to other strains — has alarmed health
officials and led to a higher than usual demand for vaccinations.
The city health commissioner, Dr. Thomas A. Farley, was among those pushing for the legislation.
State Senator Brad Hoylman, a Democrat who represents Chelsea, Greenwich
Village and Clinton, which have significant numbers of gay residents,
said he had introduced the bill after hearing of gay men who had not
been able to easily get the vaccine.
“Doctors don’t routinely stock the meningitis vaccine,” Mr. Hoylman said Friday.
Demetrios Papanakios, a staff pharmacist at New London Pharmacy in
Chelsea, said about three or four gay men a day were coming in with
prescriptions for the vaccine and taking it back to their doctors to be
administered.
“Before that we got one every 10 months,” Mr. Papanakios said.
Without insurance, the cost of the vaccine, $165, can be prohibitive,
Mr. Papanakios said. After some men reported difficulty getting
vaccinations covered by insurance, the state superintendent of financial
services, Benjamin M. Lawsky, sent out a letter in April telling health
providers that under New York law, “health insurance plans must cover such immunizations.”
Mr. Hoylman, who is gay, said he also was trying to reach men who did
not have regular medical providers or who did not want to tell their
doctors that they were gay. Black men in Brooklyn who frequent gay
clubs, parties and online meeting sites but who are not openly gay have
been most affected by the outbreak, according to the city health
department.
There have been 22 known cases of bacterial meningitis among gay men in
New York City since 2010, seven of them fatal, and the rate of infection
seemed to rise last fall and early this year, according to department
data.
There have been no new confirmed cases since February. But city health
officials are worried that there could be a further outbreak during the
annual Gay Pride celebration in New York City over three days starting
Friday, which as many as one million people are expected to attend.
Still, if signed by Gov. Andrew M. Cuomo,
the law will take effect 90 days later, too late for Gay Pride this
year. As of June 17, an estimated 13,574 people had been vaccinated as a
result of the current outbreak, according to the health department.
The bacteria are carried in the nose and mouth and can be spread through
close contact like kissing and sharing a glass. People have mistaken
the symptoms for the flu and died without seeking medical care.
This article has been revised to reflect the following correction:Correction: June 23, 2013
An earlier version of this article incorrectly stated the age at which people will be able to receive the meningitis vaccine in pharmacies. It is 18, not 11 or 12.
Result Filters
PLoS One. 2012;7(8):e41756. doi: 10.1371/journal.pone.0041756. Epub 2012 Aug 8.
Proof-of-concept, randomized, controlled clinical trial of Bacillus-Calmette-Guerin for treatment of long-term type 1 diabetes.
Faustman DL, Wang L, Okubo Y, Burger D, Ban L, Man G, Zheng H, Schoenfeld D, Pompei R, Avruch J, Nathan DM.
Source
The Immunobiology Laboratory, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States of America. faustman@helix.mgh.harvard.eduAbstract
BACKGROUND:
No targeted immunotherapies reverse type 1 diabetes in humans. However, in a rodent model of type 1 diabetes, Bacillus Calmette-Guerin (BCG) reverses disease by restoring insulin secretion. Specifically, it stimulates innate immunity by inducing the host to produce tumor necrosis factor (TNF), which, in turn, kills disease-causing autoimmune cells and restores pancreatic beta-cell function through regeneration.METHODOLOGY/PRINCIPAL FINDINGS:
Translating these findings to humans, we administered BCG, a generic vaccine, in a proof-of-principle, double-blind, placebo-controlled trial of adults with long-term type 1 diabetes (mean: 15.3 years) at one clinical center in North America. Six subjects were randomly assigned to BCG or placebo and compared to self, healthy paired controls (n = 6) or reference subjects with (n = 57) or without (n = 16) type 1 diabetes, depending upon the outcome measure. We monitored weekly blood samples for 20 weeks for insulin-autoreactive T cells, regulatory T cells (Tregs), glutamic acid decarboxylase (GAD) and other autoantibodies, and C-peptide, a marker of insulin secretion. BCG-treated patients and one placebo-treated patient who, after enrollment, unexpectedly developed acute Epstein-Barr virus infection, a known TNF inducer, exclusively showed increases in dead insulin-autoreactive T cells and induction of Tregs. C-peptide levels (pmol/L) significantly rose transiently in two BCG-treated subjects (means: 3.49 pmol/L [95% CI 2.95-3.8], 2.57 [95% CI 1.65-3.49]) and the EBV-infected subject (3.16 [95% CI 2.54-3.69]) vs.1.65 [95% CI 1.55-3.2] in reference diabetic subjects. BCG-treated subjects each had more than 50% of their C-peptide values above the 95(th) percentile of the reference subjects. The EBV-infected subject had 18% of C-peptide values above this level.CONCLUSIONS/SIGNIFICANCE:
We conclude that BCG treatment or EBV infection transiently modified the autoimmunity that underlies type 1 diabetes by stimulating the host innate immune response. This suggests that BCG or other stimulators of host innate immunity may have value in the treatment of long-term diabetes.TRIAL REGISTRATION:
ClinicalTrials.gov NCT00607230.Comment in
- Targeting innate immunity to treat long-term type 1 diabetes. [Regen Med. 2012]
- PMID:
- 22905105
- [PubMed - indexed for MEDLINE]
- PMCID:
- PMC3414482
BCG is used all over the world as a childhood vaccine. New York has much to learn from Faustman and other countries.
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