ACIP opens door to anthrax shots for first responders

first_imgOct 23, 2008 (CIDRAP News) – The federal Advisory Committee on Immunization Practices (ACIP) has opened the door to voluntary anthrax vaccination for first responders, revising an 8-year-old recommendation against that step.The committee, meeting yesterday, said the risk of anthrax exposure for emergency responders is low but “may not be zero,” and therefore first-responder agencies may want to offer the vaccine on a voluntary basis, according to information supplied by the Centers for Disease Control and Prevention (CDC) today.The CDC routinely adopts the ACIP’s recommendations.Anthrax vaccination—which currently involves six doses over 18 months, followed by annual boosters—is required for US military personnel serving in the Middle East and other high-risk areas. Nearly 2 million service members have been vaccinated under the program, according to ACIP reports.However, a number of military members have complained of negative side effects from the shot, and a lawsuit by several of them interrupted mandatory vaccinations for about 2 years starting in October 2004. Another lawsuit against the program is still in the courts.Allowing the optionThe new recommendation adopted by the ACIP does not actively encourage anthrax shots for first responders. It states:”Emergency and other responders, including police departments, fire departments, hazardous material units, government responders, the National Guard and others, are not recommended for routine pre-event anthrax vaccination. However, the committee recognized that while the risk of exposure for first responders to anthrax is low it may not be zero. Therefore, first responder units may choose to offer their workers pre-event vaccination on a voluntary basis. The vaccination program should be carried out under the direction of a comprehensive occupational health and safety program.”In 2000 the ACIP recommended against “pre-event” anthrax shots for first responders, and that stance was reaffirmed when the committee revisited the issue after the anthrax attacks of late 2001, according to an online summary of the June 2008 ACIP meeting. The reasons for reconsidering that recommendation included a growing supply of the vaccine and new data suggesting a change in the vaccine’s safety profile, plus interest from some first-responder groups, according to comments made at that meeting.Interest from emergency respondersA change in the recommendation for first responders was proposed at the June meeting by an ACIP subcommittee called the Anthrax Vaccine Workgroup. The panel’s work was described by Jennifer G. Wright, DVM, MPH.”Post-event vaccination in combination with antibiotics is an effective intervention following exposure to B[acillus] anthracis spores, but the workgroup felt that pre-event vaccination could offer additional protection beyond that afforded by antibiotics and post[exposure] vaccination by providing early priming of the immune system,” the meeting summary states. “Some respondent organizations have stated that their members would be more willing to respond to a bioterrorism event if they were vaccinated prior to the occurrence of the event.”Dr. Richard Besser, director of the CDC’s Coordinating Office for Terrorism Preparedness and Emergency Response, commented at the June meeting that a number of emergency response agencies had indicated interest in preemptive anthrax immunization for their workers, but the existing negative recommendation was seen as an impediment.Also at that meeting, the CDC’s Nancy Messonier said that the workgroup’s intent in proposing a change was “to open the door, knowing that the vaccine is commercially available and that first responder groups are at liberty to call the manufacture to obtain the vaccine themselves,” the meeting summary states.The FDA-licensed vaccine, called anthrax vaccine adsorbed (AVA) (Biothrax), is made by Emergent BioSolutions Inc. Current annual production capacity is 8 million to 9 million doses, up from about 2 million in 2002, the June meeting report says. A new manufacturing facility that is being tested will eventually boost production to as many as 30 million to 35 million doses, it says.”The workgroup felt that at the current time, vaccine supply was sufficient to support vaccination for a large group of individuals,” the report states. It says the nation may have as many as 3 million first responders, depending on how the term is defined.The work group concluded that the risk of anthrax exposure for first responders through a bioterrorism event is “undefinable,” the summary states. However, the group concluded that the available data suggest that the vaccine is safe and effective.Fewer adverse eventsThrough June 2008, 4,705 reports of adverse events associated with anthrax vaccination of military personnel were filed with the government’s Vaccine Adverse Event Reporting System, the report says. That represents a rate of 61.1 reports per 100,000 doses, as compared with 117 reports per 100,000 doses of smallpox vaccine. About 10% of the reports described “serious” adverse events.The report also said that in February the ACIP looked at data showing a decrease in local adverse events when the vaccine was given intramuscularly rather than by the standard subcutaneous route. That was an apparent reference to interim findings in a CDC study, which were reported in the Oct 1 Journal of the American Medical Association (JAMA; see link to news story below).The JAMA report said people who were vaccinated intramuscularly had fewer injection-site reactions after four doses than those who received subcutaneous shots. It also said those who received three intramuscular shots in the first 6 months had about the same immune response as those who received the standard four subcutaneous shots, suggesting that dose reduction may be possible.Discussion at the June ACIP meeting pointed out the challenges that would be posed by any effort to vaccinate large numbers of first responders, given the number and timing of doses involved. These include determining who would administer the vaccine, tracking recipients to keep them on schedule, providing liability coverage, monitoring adverse events, and caring for those who experience adverse events.Postexposure protectionAt yesterday’s meeting, the CDC reported, the ACIP also made a recommendation on postexposure protection against anthrax: 60 days of antimicrobial treatment in combination with three doses of vaccine. Vaccine should be offered within 10 days of exposure.”Anthrax vaccine is not licensed for children and has not been studied in children,” the CDC update said. “However, postexposure anthrax vaccination in children potentially exposed to anthrax may be considered on an event-by-event basis in conjunction with 60 days of antibiotics.”The recommendation on postexposure prophylaxis includes pregnant women. “Pregnancy is neither a precaution nor a contraindication. Pregnant women should receive vaccine and antibiotics if they are exposed to inhalation anthrax,” the CDC said.See also: Minutes of June 2008 ACIP meeting, including discussion of anthrax vaccine 6 CIDRAP News story “Trial offers hope for shortening anthrax-shot series”Oct 2 CIDRAP News story “To blunt anthrax attack, mail carriers to get antibiotics”last_img read more

NOPSEMA opens Shell’s Crux development for comment

first_imgThe Hague-based LNG giant Shell’s proposal to develop the Crux gas field approximately 160 kilometers north-east of the Prelude field in the northern Browse Basin, offshore Western Australia, has been open for comment.National Offshore Petroleum Safety and Environmental Management Authority (NOPSEMA) on Monday said the project is open for comment for a six-week period ending March 18, 2019.Shell, together with joint venture partners Seven Group Holdings Energy and Osaka Gas, has identified Crux project as the primary source of backfill gas supply to the Prelude FLNG facility.The proposed Crux project consists of a not normally manned (NNM) platform in water depths of approximately 165 meters of water with five production wells, minimal processing and utility systems, tied back to the existing Prelude FLNG facility via a 165-kilometer export pipeline. Crux will be operated remotely from the Prelude FLNG facility.Front-end engineering and design for the project is expected to commence in 2019 with the financial investment decision (FID) currently scheduled to occur in 2020. The project is anticipated to have a 20-year design life, with potential for extension.In the project development filing, Shell notes that there is also a potential for subsea developments that will provide hydrocarbons to the Crux platform. These developments are expected to comprise subsea production wells, completed with subsea trees, and associated subsea tie-back to the platform.From FID it will take approximately four to five years for the platform to be fully designed, constructed off-site and towed to the location.Whilst the platform is being built, the subsea production wells would be drilled and suspended until the installation of the platform facilities, after which the wells would be completed, hooked-up to the platform and brought online.last_img read more

Lightning Strike at PGA Tour Championship Injures Six People

first_imgSix people were injured on Saturday when a bolt of lightning struck a 60-foot pine at the PGA Tour championship in Atlanta, according to police.The third round of the season-ending event had been suspended for about half an hour due to stormy weather, and fans were seeking shelter. The lightning strike hit the top of the tree, which is just off the 16th tee, and shattered the bark to the bottom.Atlanta Police spokesman James H. White III says five men and one female juvenile were injured. All of them were taken to hospitals for treatment, and all were alert, conscious and breathing. The championship includes 30 players who are competing for the FedEx Cup and a $15 million prize.Golfer Justin Thomas, who was enjoying a one-shot lead through five holes when play was suspended, says he and players were eating in the clubhouse when “it felt like the entire clubhouse shook” from the thunder.The PGA Tour canceled play for the remainder of Saturday.last_img read more

Oil and Water Do Not Mix?

first_imgA federal government plan to allow exploration and possible future oil and gas drilling in the Atlantic Ocean, south of New Jersey, has Garden State environmental groups and some of its federal lawmakers rallying in opposition.The U.S. Bureau of Ocean Energy Management has established a five-year plan to investigate ocean drilling from off the coast of Virginia to Florida on the eastern seaboard. Part of that plan includes allowing energy companies to conduct seismic testing for exploration, starting south of Cape May Point, possibly as soon as this summer. According to Cindy Zipf, executive director of Clean Ocean Action, an environmental protection and advocacy organization, headquartered on Sandy Hook, “This would have extreme consequences for the entire Atlantic region.”The Bureau of Ocean Energy Management (BOEM) plan doesn’t specifically permit any drilling off of New Jersey. State lawmakers had previously adopted a resolution in opposition to it. Calls to the office of Chris Christie on Wednesday were not immediately returned before press time. Christie, however, said in 2010 “I oppose the idea of drilling off of the coast of New Jersey…New Jersey’s coastline is one of our economic engines.”Zipf on Wednesday echoed the Governor’s sentiments believing “You can’t have an oil-based economy and a clean ocean economy in the same ocean. They don’t mix.”Even allowing seismic testing, Zipf maintained, could impact marine life. And drilling anywhere could have repercussions all along the coast, she added.“While that may sound like it’s far away,” what is being proposed, she said, “in the ocean nothing is far away. If you have a spill it will flow up the shore.”Raising the clarion call for Zipf and other groups along with U.S. Senators Cory Booker and Robert Menendez (both NJ-D) and U.S. Reps. Frank Pallone Jr. (D-NJ) and Frank LoBiondo (R-NJ) was that, given New Jersey isn’t technically in consideration the BOEM did not plan any public hearings on the proposal; the bureau plans a public meeting, where individuals can question bureau representatives who will provide information and literature, but without public comments and opinions being offered in the official record.“It’s a lack of due process and terrible in terms of good government,” Zipf charged.Whether New Jersey gets a public hearing, the public can offer written comments either by mail or online until March 30, Zipf said.A phone call to the BOEM’s Washington, D.C. headquarters on Wednesday was not immediately returned.A letter signed by the senators and congressmen seeking a public hearing on the matter has been sent to the BOEM’s offices, representatives for Booker and Menendez’s office said on Wednesday.At a press conferences conducted in Atlantic City on Wednesday, with the lawmakers and environmentalists, Pallone said “We’ve seen that oil spills don’t respect state borders,” and an environmental incident could jeopardize not only the environment but also the shore area’s economy, according to a released statement.— By John Burtonlast_img read more

Officials Try To Clear the Air on Cell Tower in Little…

first_imgBy Jenna O’Donnell |LITTLE SILVER – It was standing room only on Monday night when several hundred Little Silver residents filled a school auditorium to ask their mayor and council why they had allowed Verizon to build a cell tower right in the center of town – less than 500 feet away from Markham Place School.As part of an agreement made with residents at last month’s borough council meeting, Mayor Robert Neff Jr. and members of the council shared an account of how and why they had agreed to build the tower with Verizon and brought in a telecommunications engineer, who showed measurements of radiofrequency waves emitted by the tower to be well within range limits. Still, most residents remained skeptical of the tower’s safety and questioned the potential impacts on health, property value and the limits established by the FCC, which is not a health organization.One resident, Michael Goldfarb, M.D., pointed out that other things like lead, asbestos and cigarettes were once deemed safe before, only to later be proven otherwise.“I lived in an era where smoking was good for your throat,” Goldfarb said. “I’ve lived through these other things that were supposed to be no problem. Well, they are problems.”The 95-foot cell tower was erected by Verizon last month in a parking lot behind borough hall, and turned on at the end of May. More carriers are expected to install cellular “nodes” in coming months. The monopole replaced an aging communications tower that had been used by police, fire and emergency responders and was meant to be a fix for spotty coverage.Verizon became involved after moving to install its equipment on the roof of a nearby CVS Pharmacy in June of 2014. At that time, the borough was budgeting to replace the existing communications tower and negotiated with Verizon to install the cell tower on borough property, where it would be combined with the antenna needed by police and emergency services. Verizon, which funded the construction of the tower, will sell it to the borough for $1 upon completion and has a 25-year lease that will pay the borough $1.3 million. Part of the thinking in zoning borough property to allow cell towers had been that this would give the borough more control over location, height and use, said Councilman Don Galante, who read a statement summarizing the process that lead to the tower.Once Verizon demonstrated a demand for service in the downtown area, Galante said the borough had little choice in the matter. As per the Telecommunications Act of 1996, local governments cannot block the installation of telecom infrastructure, no matter how unsightly. Galante, who has a grandchild in Little Silver schools and a daughter-in-law teaching at Markham Place, said he wasn’t too fond of the aesthetics either.“Federal law is federal law,” he said. “Do I want a tower in downtown Little Silver? No. I can’t stop it. All I can control is where it goes.”Still, dozens of residents stood up during a lengthy public forum with questions about what the borough was doing to remove or relocate the tower.Borough officials could not go into specifics as to what actions were being taken legally, but told residents that all options were being explored.“Our goal is to understand all of our possible solutions and resolutions to this problem,” said Neff, noting that the borough had met twice with Verizon to understand what the company was willing to do. He added that while local government does not typically move very quickly, they had been working nonstop to try to address concerns. “We did not anticipate the volume of discontent,” he said.That discontent has manifested in “Get the Cell Out” lawn signs across the borough and a grassroots community group known as Little Silver Against the Cell Tower, which has two members as part of a cell tower committee with Neff, two council members and the board of education president.Politicians have also grabbed hold of the issue, with Sen. Richard Codey (D-27) planning to draft a bill that requires cell towers to be located at least 2,500 feet away from schools. Christopher Healy, a candidate for borough council, proposed a November ballot referendum to move the tower to a more suitable location.Where and how the nearly complete cell tower might be moved is still unclear, as the borough is legally bound to a 25-year lease agreement. But some residents were hopeful that something could be done.“There’s communication happening now,” said Marc Gasperino, one of the community members on the cell tower committee. “I think there’s a lot of good people who love this community pushing forward on this.”This article was first published in the June 15-June 22, 2017 print edition of The Two River Times.last_img read more

Nelson Clubsters open Spring hoop season in Salmon Arm

first_img“We are often physically outmatched by older U17 teams,” said coach Jeremy Phelan.Despite the size and age discrepancy, Nelson jumped to a 4-1 lead with baskets from Colton Jones. However, at the three- minute mark our starting center Vinnie Watson went down with a dislocated knee and we had to wait for the ambulance to take him to the hospital.Nelson lost its momentum and were outmatched without Watson’s size in the post. After a short break Nelson played the Synergy U15 squad.The Grade 8 twin duo of Brock and Dyllen Dixon controlled the back court along with Jared Martin against the junior Synergy opponent.The tables turned against the U15 Synergy, as Nelson had the overall size advantage and were able to out-rebound and out-muscle the slighter U15s.The line of Rob Dixon, Matosevic, Stryder Scott, Teja Legare, and Colton Jones managed to score at will and maintain leads through each quarter and finally secure the 41-34 win. Nelson Club Basketball team traveled to the North Okanagan to begin the spring lead against teams from Salmon Arm.Josh Matosevic led the U17s in scoring in a 59-27 defeat against a much bigger and stronger Synergy U17’s.Nelson has no U17s on the team as the club is filled with younger players.last_img read more

Feke: from South Africa to Ghana and back

first_img“What make me a great entrepreneur? I have a curious mind. I am always asking: If I do this, what happens?” says Siphoakazi Feke. (Image: Barry Hiles) Sulaiman Philip“When I make my first billion I will go back to Lusikisiki and change lives. I am from there, I know what needs exist.” It would be easy to dismiss Siphokazi Feke as simply boastful if all you did was listen to her laugh as she speaks those words.As she outlines the path she wants her life to take she giggles like a schoolgirl, but there is a confident edge to her voice, a strength that comes from having overcome obstacles to build a successful business.“If I think about it, I am risk averse. Failure terrifies me. Life had other plans though. I was forced to face failure,” she says. “I have learned there is just one question you ask yourself: how do I use this experience to move on to the next level?”Feke is the managing director of BW Medical Group, a medical travel agency that channels African – most from the DRC, Ivory Coast, Kenya and Ghana-  patients to South Africa for treatment. It also runs a dialysis and urology clinic in Ghana, where she lives for most of the year.For the rest of Africa, South Africa remains the standard for good medical care; those who can afford it choose to have elective surgery in South Africa. “In Ghana they cut you to remove kidney stones so you’re looking at weeks of recovery. In South Africa, we use shock wave therapy that can be done as an outpatient.” Know your marketThere are no secrets to success, Feke will tell you, only hands on hard work and knowing your market. In Ghana, as it is in most of Africa, learning about your market is difficult. There is not much in the way of data to begin with, but a good entrepreneur works around that. Before sourcing the funding and founding the BW Medical Centre in Accra in 2012, Feke sought data on the number of patients needing dialysis in Ghana’s capital.“Funders want data but no-one keeps those records. What they do have are death certificates with the cause of death listed. I looked through those records for any deaths that could be linked to renal failure and the numbers of patients on chronic medication for hypertension and diabetes, looked at the growing middle class and from that I could extrapolate from that a need existed for a clinic. After that it is gut feel and hard work.”In two years the clinic in Ghana has gone from a start-up struggling to find funding to an established and trusted clinic treating Accra’s influential. “We are at the point now where doctors treat patients, nurse’s care for them and patients pay. It’s a self-sustaining business. Now we can set our sights on the rest of ECOWAS,” Feke says.Africa is alive with opportunity, she explains. It is easier to convince funders to support projects in African countries other than South Africa. For many, South Africa is a mature economy with resources unavailable to more deserving African economies.“The World Bank, for example, will fund a start up in Nairobi before they would one in Cape Town. It’s one of the reasons I moved to Ghana. As an entrepreneur you find innovative ways to find cash. You tweak your dream, you hustle. You do what you need to do to get your vision up and running. South African entrepreneurs need to remind themselves the world is open to investing in Africa. We Africans have the opportunity to build African conglomerates. We can create wealth by Africans for Africa.” Qualified nephrologistFeke was the first black woman to qualify as a clinical technologist with a speciality in nephrology in South Africa. In 1998, when she started working at HF Verwoerd Hospital – now the Steve Biko Academic Hospital – her race was still an issue. “Families would ask why I wanted to touch their father. No-one wanted to be treated by me. A paradigm shift was needed before I could do my job. Fortunately there were people like [senior clinical technologist] Blake van Aswegen, who went out of their way to accommodate me.”In 2001, Feke quit clinical practice and went to work in the pharmaceutical industry. She did sales before moving into brand and product management. Impressed by her insights into the African market, her employer sent her back to school, where she went through the Gordon Institute of Business Science’s Programme for Management Development. It was an education that stood her in good stead while working for a multinational pharmaceutical company, but proved a hindrance when she went out on her own.“I had to unlearn everything and learn how Africa really worked. It’s an unfortunate thing to say but South Africans need to make a mind shift about Africa. We can’t just turn up and expect people to listen. We need to develop an affinity for the region, learn how Africa works, how cultures differ.“Johannesburg is the melting pot for business in Africa, but outside our borders is where the opportunities are. If you are not going to invest the time to learn, then choose to invest somewhere else. Somewhere you consider safe.”Along the way there have been people who have assisted this global South African: the clinician who paid her rent when she arrived in Pretoria, the manager at Adcock Ingram who encouraged Feke to believe in her talents, the entrepreneur who loaned her the seed money for BW Medical and the Metropolitan Insurance Group which took a chance on her vision. Promise of a schoolRight at the beginning, though, was Nelson Mandela, the man who promised her a school. “In 1990, I was in school in Qunu, the same school that Madiba attended. I met him when he came home and he promised that he would build us a school before he became president. Not just walls but a school with an entire support system to give kids a chance.”On her first attempt Feke failed a single matric subject – she passed the year, but not well enough to go on to study medicine. It was then that she got advice from her father that still resounds with her today. “My father suggested that I was still young enough to go back and redo matric. I still remember what he told me: failure is an event; it does not need to define who you are.”Feke’s trajectory has unfurled not with cheery inevitably; her success is built on desire and the will to not bow to failure. She traded the comfort of her rural home for Durban, then Pretoria and finally Ghana.She lost her fear of the challenge of the new when she moved to Pretoria to do her in-service training. “I was standing at the station at 4am with my luggage. It was dark and there was no one to meet me because the hospital was not informed of my arrival, and no idea which direction the hospital was in. For a girl from rural Transkei it does not get scarier than that.”last_img read more