Georgia Gazette Friday June 26, 2009

Join host Rickey Bevington tonight for Georgia Gazette. On tonight's show … free HIV tests for all Georgians tomorrow … we show you just how easy it is. Jazz crooner Michael Feinstein talks about Johnny Mercer’s influence. And who wins our weekly giveaway? Find out tonight. These stories and more tonight on Georgia Gazette at 6, 7 in Athens, hear our show any time at www.gpb.org/georgiagazette, and download a free podcast on iTunes.

Georgia Gazette Wednesday, June 24, 2009

Join host Rickey Bevington tonight for Georgia Gazette. On tonight's show… Skyrocketing health care costs in Georgia... a new reports explains why. Thousands of Georgia veterans at risk for HIV and other diseases. Is the VA to blame? We visit the Georgia Dome's first natural grass field.These stories and more tonight on Georgia Gazette at 6, 7 in Athens, re-broadcast at 11, hear our show any time at www.gpb.org/georgiagazette , and download a free podcast on iTunes.

High HIV Rates in South

A new internet data map offers a first-of-its-kind, county-level look at HIV cases in the U.S. and finds the infection rates tend to be highest in the South. It also finds the infection is concentrated in about 20 percent of American counties, with the highest numbers of cases in population centers like New York and California. However, parts of the South appear especially hard-hit by the virus. More than half the 48 counties with the highest rates of the AIDS-causing infection were in Georgia. The map was put together by the National Minority Quality Forum, a nonprofit research organization that has done other disease maps.

(Associated Press)

AP: VA Clinics Fail to Follow Standards

The Associated Press has learned that fewer than half of Veterans Affairs clinics given a surprise inspection last month followed proper standards for colonoscopies and other minimally invasive procedures - even after the agency learned that mistakes may have exposed thousands of veterans to HIV and other diseases. The VA's findings, obtained by the AP, suggest that errors in colonoscopies and other procedures performed at VA facilities may be more widespread than initially believed. The report will be released at a House hearing Tuesday. Since February, the VA has told some 10,000 patients in three states to get tested. More than 50 patients tested positive for infections, including six for HIV. It can't be proven that their infections came from the procedures.

(Associated Press)

Second HIV Patient At Augusta VA Clinic

The U.S. Department of Veterans Affairs now shows six former patients have tested positive for HIV since mistakes at VA hospitals in Tennessee, Florida and Georgia possibly exposed them to infections. An update on the VA's Web site shows a second patient at the ear, nose and throat clinic in Augusta, Ga., has tested positive for HIV. Three former colonoscopy patients at the VA hospital in Miami and one at the VA hospital in Murfreesboro, Tenn., have tested positive for HIV. The six are among about 10,000 former VA patients warned that they are at a "small risk of infection" due to equipment that wasn't properly cleaned or operated. Forty-five former patients have tested positive for hepatitis. Congressional hearings are set for June 16 and June 24.

(Associated Press)

U.S. Senators to Hold Hearings After Veterans Test Positive for Infections

A U.S. Senate committee will ask officials with the U.S. Department of Veterans Affairs how mistakes at three VA medical centers in the Southeast, including a clinic in Augusta, may have exposed veterans to infections such as HIV and hepatitis.

The Senate Committee on Veterans Affairs has set a June 24 hearing for VA officials to explain how mistakes with endoscopic equipment possibly exposed patients to infectious body fluids in Augusta, Murfreesboro, Tenn., and Miami.

The committee's announcement comes shortly after a U.S. House of Representatives Veterans Affairs subcommittee announced it would hold its own hearing on June 16.

The VA has warned more than 10,000 former patients at the three medical centers to get follow-up blood checks. Five of the patients have tested positive for HIV so far, and 43 have tested positive for hepatitis.

In Augusta, the problem affected rhinoscopes in an ear, nose and throat clinic at the Charlie Norwood VA Medical Center. Officials in February said an employee improperly sterilized the rhinoscopes with disinfectant designed for exam tables instead of a stronger one specifically designed for the scopes.

A top doctor at the federal agency has stressed that the positive results for the diseases may not have come from hospital mistakes.

Veterans Affairs Will Avoid HIV Link

A top doctor at the U.S. Department of Veterans Affairs says former patients who tested positive for HIV or hepatitis will not be able to show they were infected by tainted equipment at VA medical centers. Five patients have tested positive for HIV and 33 have tested positive for hepatitis since the VA started notifying more than 11,000 people treated at three VA medical centers in Miami, Georgia and Tennessee that they may have been exposed to infectious body fluids after using endoscopic equipment that wasn't properly sterilized. The blood tests are continuing. The agency has stressed that the positive results for the diseases may not have come from hospital mistakes. The VA's chief patient safety officer, Dr. Jim Bagian, said he doesn't think anyone will ever know.

(Associated Press)

GA VA Patient Tests HIV Positive after Contamination

A patient at a Georgia Veterans Affair clinic has tested positive for HIV after being exposed to contaminated medical equipment.

The Department of Veterans Affairs says unverified tests show that this is the third person to have the virus that causes AIDS among thousands getting blood tests because equipment wasn’t properly sanitized. That’s one patient each from Murfreesboro Tennessee, Augusta Georgia, and a Miami medical facility.

The contaminated endoscopic machines exposed the patients to the body fluid of others.

The VA also said six tests have come back positive for Hepatitis B, and 19 positive tests for Hepatitis C among the three locations.

(Associated Press)

Veterans to be Tested for HIV and Hepatitis After Improper Sanitization at Medical Clinic

About 1200 military veterans need to undergo testing for HIV, hepatitis B and hepatitis C after personnel at the Charlie Norwood VA Medical Center discovered that rhinoscopes at an ear nose and throat clinic were improperly sterilized.

The testing involves veterans who underwent procedures in which the rhinoscopes were used at the clinic between January and November, 2008. Officials at the VA center, in Augusta, say the risk of infection is extremely small.

The disinfectant used to clean the scopes during that time period was designed for surfaces such as exam tables, and not one recommended by the rhinoscopes' manufacturer, although chemical activity is similar, according to Dr. John Brice, chief of medicine and acting chief of staff at the medical center.

Doctors use the rhinoscopes to exam sinuses and the upper airway passages of patients.

Brice says an employee was apparently not trained properly on the cleaning procedures. He says the problem began when a nurse at the clinic left, and rapid employee turnover followed. The problem was caught during an annual review of procedures at the clinic. Brice says the center is stepping up training procedures and increasing reviews there to quarterly, at the least. He says an investigation into the matter is ongoing, and that scopes, at this time, are being cleaned at another location.

Brice says the issue was confined to the clinic, and did not happen at the hospital there.

The center is this week sending out letters to the veterans who were possibly exposed to infections.

The VA center has a hotline for the veterans. For more information, call (706) 731-7229 from 8 a.m. until 4 p.m. on weekdays, or (800) 836-5561 after hours.

For more information from the VA, click here.

CDC: gov't underestimating AIDS spread

The number of Americans infected by the AIDS virus each year is much higher than the government has been estimating, U.S. health officials reported, acknowledging that their numbers have understated the level of the epidemic.

Experts in the field, advocates and a former surgeon general called for more aggressive testing and other prevention efforts, noting that spending on preventing HIV has been flat for seven years.

Since AIDS surfaced in 1981, health officials have struggled to estimate how many people are infected each year. It can take a decade or more for an infection to cause symptoms and illness.

"This is the most reliable estimate we‘ve had since the beginning of the epidemic," said Dr. Julie Gerberding, the CDC‘s director. She said other countries may adopt the agency‘s methodology.

The new infection estimate is based on a blood test that for the first time can tell how recently an HIV infection occurred.

The new estimate relies on blood tests from 22 states where health officials have been using a new HIV testing method that can distinguish infections that occurred within the past five months from those that were older.

Yearly estimates allow better recognition of trends in the U.S. epidemic. For example, the new report found that infections are falling among heterosexuals and injection drug users.

But they also lamented the CDC‘s finding that infections continue to increase in gay and bisexual men, who accounted for more than half of HIV infections in 2006. Also, more than a third of those with HIV are younger than 30.

Some advocates say that suggests a need for more prevention efforts, particularly targeting younger gay and bisexual men.

For years, AIDS was considered a terrifying death sentence, and since 1981, more than half a million Americans have died. But medicines that became available in the 1990s turned it into a manageable chronic condition for many Americans, and attention shifted to Africa and other parts of the world.

Last week, President Bush signed a $48 billion global AIDS bill to continue a program that he called "the largest commitment by any nation to combat a single disease in human history."

But some advocates complain that CDC‘s annual spending on HIV prevention in the United States has been held to roughly $700 million since 2001, while costs have risen. (That‘s about 3 percent of what the federal government spends on AIDS; much of the rest is on medicines, health care and research.)

Whether more funding comes or not, the revised estimate clearly is a "wake-up call to scale things up," said Dr. Kevin Fenton, who oversees CDC‘s prevention efforts for HIV/AIDS.

Some said more attention needs to focus on prevention among blacks, who account for nearly half of annual HIV infections, according to the new CDC report.

A recent report by the Black AIDS Institute concluded that if black Americans were their own nation, they would rank 16th in the world in the number of people living with HIV.

"We have been inadequately funding this epidemic all along. We need to step it up," said former U.S. Surgeon General Dr. David Satcher, who is now an administrator at Atlanta‘s Morehouse School of Medicine.

The new estimate has been anticipated for a long time. The CDC began working on the new methods nearly seven years ago.

Late last year, advocates said they had heard the figure was about 55,000 and pressed the CDC to release it. Agency officials declined, saying they were submitting their research for medical journal review.

"These are extremely complicated statistical methods," and CDC officials wanted the work to be thoroughly reviewed by outside experts, Gerberding said. The CDC‘s findings are being published in the Journal of the American Medical Association.

Until 1992, the number of diagnosed AIDS cases was used to predict how many people were newly infected each year. That method produced an estimate of 40,000 to 80,000. More recently, the CDC focused on infections among men who have sex with men, who account for about half of new HIV diagnoses.
___

CDC HIV fact sheets: http://www.cdc.gov/hiv/resources/factsheets/

JAMA: http://jama.ama-assn.org

(The Associated Press)

Click here for more GPB News coverage about the CDC.

Woman with HIV gets 3 years for spitting in face

A woman diagnosed with HIV has been sentenced to three years in prison for spitting in another woman's face and proclaiming "I hope you get AIDS."

The woman, 43-year-old Audrey D. Lewis, pleaded guilty Monday to aggravated assault in a Columbus courtroom.

Police said a 24-year-old went to lock the apartment door of a friend who was being arrested Oct. 3 for simple battery against Lewis. Assistant District Attorney Doug Breault said Lewis approached the woman and the two began to quarrel.

Breault said Tuesday that Lewis will have to serve the full sentence because she has three prior felonies.

Defense attorney Judy Dunlap said the three years was unwarranted. She said she was hoping for about three months.

(The Associated Press)

HIV cases up in the South

HIV cases are on the rise in the South. This according to a new report by the Southern AIDS Coalition. It says federal funding to fight HIV/AIDS focuses on wealthy parts of the country. While the number of AIDS deaths dropped in the nation between 2001 and 2005, it rose in the South. The report says the South has more new HIV cases than any other region, but ranks last in overall funding.

Boost for ailing minority health care

Minority health care in several southwest Georgia counties gets failing marks according to a new report. The 2008 Health Disparities Report (.pdf download) says that while racial and ethnic minorities make up about a third of Georgia's population, they are much more likely to have health problems.

The Office of Minority Health, which put out the report is working to equalize health care access for minority and non-minority populations in Georgia.

Kristal Ammons of the Department of Community Health says Muscogee County's grade was among the lowest statewide:

“...particularly in the overall report card -- they received a grade of 'F' for prenatal care and maternal health outcomes.”

Representatives met with local officials in Columbus on Thursday to discuss ways of improving minority health care.

Ammons says a matrix of poor education, poverty and economic hardship are a big part of the problem, but adds that many other counties received higher ratings.

The group plans to distribute $1.5 million in improvement grants statewide. The funds will also cover other health issues including cardiovascular disease, cancer, diabetes and HIV/AIDS.

The group plans to set up coalitions with local officials and health care providers in Fort Valley, Valdosta and Brunswick, among others statewide.

Click here for more GPB coverage of health issues in Georgia.

CDC: Moms pre-chewing food gave HIV to kids

For the first time, health officials report that the AIDS virus can be spread by a mother pre-chewing her infant's food, a practice mainly seen in poor, developing countries.

Three such cases were reported in the United States from 1993-2004, government scientists said Wednesday in a presentation in Boston at a scientific conference.

It's blood, not saliva, that carried the virus because in at least two of the cases the infected mothers had bleeding gums or mouth sores, according to investigators at the U.S. Centers for Disease Control and Prevention.

CDC officials say more study is needed. But they are asking parents and caregivers with HIV not to pre-chew infants' food, and are trying to educate doctors about this kind of transmission.
Health officials believe chewed-food transmission is rare in the United States, where such behavior is considered unusual. In some countries, mothers do it because they have no access to baby food or a means of pulverizing food for toothless infants.

"But even one case is too many," said the CDC's Dr. Ken Dominguez, who helped investigate the U.S. cases.

The first involved a 15-month-old African-American boy in Miami, diagnosed in 1993. His great-aunt was infected with HIV and pre-chewed food for the boy when he was between the ages of 9 months and 14 months.

Then a 3-year-old Caribbean-American boy was diagnosed in 1995, also in Miami. His HIV-infected mother pre-chewed food for her son.

Still uncertain they had definitively connected the practice to the spread of HIV, the doctors wanted more evidence. It was years later before they could confirm a third case, which occurred in 2004. A 9-month-old African-American girl was diagnosed with HIV in Memphis. The mother began pre-chewing the girl's food when she was about four months old.

All three children were infected with HIV at a time they would have been teething and had inflamed gums. It may be that both a caregiver and a child must have wounds in their mouths for the virus to have a good chance of passing from one bloodstream to another, the investigators said.

Previous studies have linked pre-chewing to the spread of other infections including Helicobacter pylori, a bacteria that causes stomach ailments, and streptococcal pharyngitis, which triggers sore throat. That research, too, is preliminary and needs to be confirmed, CDC officials said.

In developing nations without other feeding options, any campaign against pre-chewing could be nutritionally harmful, said Kimberly Hagen at the Emory Center for AIDS Research in Atlanta.

"This would really take a lot of thinking before you could say, 'We've had three cases in 11 years, so you have to stop pre-chewing your child's food,'" Hagen said.

___
On the Net:
Conference on Retroviruses and Opportunistic Infections:
http://www.retroconference.org/2008/

The Associated Press)

HIV rates higher than previously reported

Federal health officials are revising their estimate of how many people are infected by HIV each year, and advocacy groups say the new numbers could be higher. The U.S. Centers for Disease Control and Prevention has been estimating about 40,000 new HIV cases occur in the nation each year. At a national HIV prevention conference in Atlanta this week, however, advocates claim the new estimate is 55,000 or higher. The CDC says new numbers will be official early next year.

Man arrested for infecting woman with HIV

Athens police have arrested a man accused of infecting a woman with HIV without her knowledge. Authorities say the woman, who recently discovered she has AIDS, traced back the infection to Keyvin Shurrod Lyle. He has been charged with felony reckless conduct. In Georgia, it is a felony to not disclose HIV positive status to a sexual partner.

State Supreme Court overturns two malpractice suits

In a pair of decisions, Georgia’s Supreme Court overturned two medical malpractice lawsuits.

The Court ruled a Glynn County man cannot sue doctors who mistakenly infected him with HIV.

The patient was two moths old when doctors when doctors at the Medical College of Georgia Hospital performed open-heart surgery, using contaminated blood.

The patient suffered a decade of health problems attributed to his heart condition. He then sued in 2001 after discovering he was HIV-positive.

Attorneys for the defense argued the time to file a lawsuit had passed.

In its ruling, the Court said the open-heart surgery did not cause the patient to develop AIDS, but that a lack of treatment led to the illness.

In another ruling today, the Court says a judge cannot award money in a wrongful death case if the jury chooses to award nothing.

The family of a baby, who died at 15 months, says doctors at Columbus Healthcare System failed to diagnose a rare blood condition.

However, at trail, expert testimony showed the baby died due to massive head injuries.

A jury awarded $100,000 for the child’s pain and suffering, but no damages for the infant’s wrongful death.

Later, the judge added $1 million, saying it was not right to acknowledge malpractice, but award nothing for a wrongful death.

The Supreme Court overturned the judge’s $1 million award and has sent the case back for re-trial.

Medical College of GA gets funds to treat HIV

The Medical College of Georgia has new federal funds for HIV testing and education. The $5 million dollars provides medical care for 1,000 HIV patients, a third of whom are indigent. MCG’s School of Dentistry and Department of Psychiatry and Health Behavior also participate in their care.