Q&A: H1N1 vaccine and Guillain-Barré risks?

Should I get the swine flu (H1N1) vaccine if I’ve had Guillain-Barré syndrome? —J.M., Irvington, N.Y.

That depends in part on your risk of getting swine flu and becoming seriously ill if you do. It’s true that some studies have associated flu vaccines with a slight increase (about one person per million) in the risk of developing Guillain-Barré syndrome (GBS), a neurological disorder. And some evidence suggests that a previous case of GBS increases your risk of getting it again. But the flu itself can also cause GBS as well as such complications as pneumonia and in rare cases, death. If you’re among the priority groups for H1N1 vaccination—including pregnant women, health-care workers, and people ages 25 to 64 with underlying conditions such as diabetes and heart or lung disease—the shot’s benefits probably outweigh its risks.

Preventable hospital infections: To Err is Human, to delay is deadly

Ten years ago, the Institute of Medicine (IOM) released To Err is Human, reporting that as many as 98,000 Americans die every year from preventable medical errors. Today, on the report’s 10-year-anniversary, Consumer’s Union Safe Patient Project is hosting a forum in Washington, DC to call attention to the fact that today, we’re no safer that we were 10 years ago and to draw attention to their report To Err is Human – To Delay is Deadly which estimates that preventable medical harm still accounts for over 100,000 deaths each year.

The event will be attended by prominent patient safety leaders to discuss what needs to happen to keep patients safe, including former U.S. Treasury Secretary, Paul O’Neill, who wrote a recent op-ed in the New York Times on medical harm; Arthur Levin, a member of the original IOM committee and Director of Center for Medical Consumers; Dr. Rick Shannon, Chairman of the Department of Medicine of the University of Pennsylvania Health System, whose work has been featured in the Wall Street Journal, ABC and NPR; Merrill Goozner, author of The $800 Million Pill: The Truth Behind the Cost of New Drugs; Charles Ornstein with ProPublica who co-wrote a groundbreaking series detailing serious failures in oversight by the California Board of Registered Nursing; Maggie Mahar, health care fellow at The Century Foundation, writer of HealthBeat Blog and author of Money-Driven Medicine; and leading patient safety advocates.

BPA may affect sexual function in adult men, study finds

While the Food and Drug Administration continues to review the safety of the chemical Bisphenol A (BPA), a new epidemiological study finds for the first time that the ubiquitous substance may well have a serious impact on male sexual function in adults who are exposed to substantial amounts. The men affected worked in factories that manufactured BPA-containing materials and were exposed to relatively high levels of BPA.

Lower levels of BPA exposure are also a concern, and our latest tests found the chemical in just about every canned food we looked at. In that recent investigation, we found that consumers eating just one serving of the canned vegetable soup we tested would get about double what the FDA now considers typical average dietary daily exposure--though that is still far less than the occupational exposures that were noted in factory workers.

BPA is a chemical that can mimic estrogen, and it has been used for years in clear plastic bottles and food-can liners. Some studies have linked exposure to BPA with reproductive abnormalities and a heightened risk of breast and prostate cancers, diabetes, and heart disease. Use of the chemical has been restricted in Canada and some U.S. states and municipalities because of potential health effects. An FDA scientific advisory panel weighed in a year ago that the agency’s rationale for setting safety standards for BPA was inadequate. A congressional subcommittee determined earlier this year that the FDA relied too heavily on industry sponsored studies.

Not just for pigs and humans: Swine flu advice for your pets

Add cats to the list of animals that have caught the H1N1 (swine) flu. Last week there was a flurry of reports that a 13-year-old Iowa feline had tested positive for the virus. The cat is reported to have fully recovered. But should you be worried about your pet catching swine flu? And can you get the flu from your pet?

According to the Centers for Disease Control and Prevention, your pet should be more wary of you than the other way around. While there are reports of some animals getting the flu from their pet parents, there appears to be no evidence of pets spreading the disease to humans. Ferrets are particularly susceptible to influenza—a trait that has led to the mammal being a subject-of-choice for influenza studies.

On the other end of the spectrum, there are no reports of dogs catching the swine flu, but our "best friend" remains susceptible to a different strain of flu, canine influenza. Poultry, including turkeys, have been infected with H1N1 already, but it’s unknown if pet birds are susceptible to the virus. And while it’s known that pigs can catch the swine flu, it’s not clear if any of the potbelly variety, which are popular as pets, have come down with the H1N1 flu.

Surgical masks appear to be just as effective as N-95 respirators

After much ado, surgical masks appear to be just as effective as N-95 respirators at preventing the spread of the flu. Over the weekend it was reported that a review of the data in a study that said N-95 respirator masks were superior to surgical masks negated that conclusion and the study was retracted. The study, presented last month, was, unfortunately, a critical data point that health policymakers used the study to recommend the more expensive N-95’s for flu control.

The researchers now say that there are no significant differences between facemasks and N-95 respirators at preventing flu. That confirms another recent study that we reported on last month from the Journal of the American Medical Association. In that randomized controlled trial by researchers in Canada, N-95s and masks performed about equally.

Facemasks, such as surgical masks, are designed to block large particles that may carry viruses and other pathogens that can cause illness. In addition to blocking those large droplets in sprays and splashes, N-95 respirators are designed to block even smaller particles—at least 95 percent of very small particles in testing when fitted correctly. It appears that blocking the larger respiratory droplets that are most likely to spread the influenza virus is more important than blocking smaller particles, and either mask can do that.

Q&A: Are megadoses of B vitamins dangerous?

I take a multivitamin containing 1,000 to 3,000 percent of the daily value of vitamins B12, B6, thiamin, and riboflavin. Are such doses dangerous? —A.R., Riverside, Calif.

Probably not, but for healthy people there’s little or no evidence that megadoses of those B vitamins are useful, either. Only B6 has been linked to a possible side effect, nerve damage. And that was at higher doses—7,000 percent of the daily value (DV), taken long-term—than you’re taking. Megadoses of B12 appear to be safe, since studies of pernicious-anemia treatment with injections of more than 40,000 percent of the DV haven’t reported any side effects. Thiamin and riboflavin also appear harmless because the body absorbs only a fraction of the huge doses; the rest is excreted in the urine.

It’s tough being perfect, but we found 7 condoms that are

I get a lot of interesting reactions when I tell friends I’m covering our tests of condoms. Their excitement wanes a little when I say we don’t test condoms by personally trying them out. But they tend to be quite impressed by the scope and scale of what we put the humble latex sleeves through in our labs—as well as the sheer number of condoms we buy to ensure our sample sizes are large enough to draw statistically valid conclusions.

For our latest test, our intrepid mystery shopper bought more than 15,000 condoms—yes, one guy, 15,000 condoms. Lab technicians then unrolled them, stretched them, measured them, visually examined them, dunked them in liquid (to check for leaks), and inflated them with air until they burst to determine which ones are strong enough to put your trust (or you or your partner) into.

Seven of the 20 models we tested earned a perfect score, indicating they were not only stronger and more reliable than most, but also had no leaks or flaws in their packaging. Those top seven include one Durex, two Lifestyles, and four Trojan models (Ratings available to subscribers). Alas, one of the more playful condoms we tested, the Night Light glow-in-the-dark model, didn’t fare as well, earning our lowest score for strength and exceeding the allowable number of samples with holes. But it did live up to its name on the glow front.

Video of flu shot cheerleader is misleading

"Dad, have you seen the video of this cheerleader? All of my friends have and they don’t want to get vaccinated if this could happen to them. It seems strange that she can do some things and not other things.  Is this for real?"

That’s the response John Santa, M.D. and Director of the Consumer Reports Health Ratings Center, got from his 23-year old son recently after being reminded to get the two (seasonal and H1N1) flu vaccines.  The concern echoed those expressed by many others after the story was released by FoxNews in mid-October. It reported that a Washington Redskins cheerleader, Desiree Jennings, was diagnosed with a rare neurological disorder called dystonia alleged to be caused by a severe reaction to the seasonal flu shot.  The online story, published October 13th, described that "Desiree now has difficulty speaking, walking, and even eating. During an interview with FOX 5, she had several seizures. The effects are irreversible."

Over the past two weeks Desiree’s story has been picked up by quite a number of other news outlets and blogs and featured on the home page of Generation Rescue, Jenny McCarthy and Jim Carrey's Autism Organization, with the title "Redskin Cheerleader Disabled by Flu Vaccine".

But this is misleading. Dystonia is a rare movement disorder in which prolonged muscle contractions cause twisting and repetitive movements or abnormal posturing. These involuntary movements may affect a single muscle or a group of muscles in the arms, legs, neck or the entire body.  But neurologists all over the country are commenting on professional listservs, saying that Desiree’s video doesn't look like dystonia at all, but rather is likely to be a psychogenic movement disorder, that is, a condition thought to have a psychological origin, and for which there is no physical explanation.

Using face paints this Halloween?

I can’t be the only parent who is engaged in the last-minute scramble to please the Great Pumpkin.  I pulled orange Halloween storage boxes out of the attic last night and my kids and I dreamed about costumes far too complicated for the time we have left to make them.  Then I read these items that came through our internal news alerts:

• Recent findings by The Campaign for Safe Cosmetics found that 10 out of 10 of the face paint products they sent to independent labs for testing contained low levels of the neurotoxin lead (there is no safe level of lead exposure for children).  According to the report, 6 out of 10 of the face paints tested included nickel, cobalt and chromium, all of which may cause lifelong skin sensitization.
• A Medill Report notes that despite FDA requests for recalls, cosmetics can stay on the market for months before being deemed too hazardous for production. To make matters worse, some products that pass cosmetic safety standards can expire while on the shelf. When a product expires its ingredients begin to deteriorate. 

Swine flu scams on the rise

Whenever a public health or safety issue looms large, a certain segment of our economy tries to profit from the fear and confusion. We’ve seen it happen during the bird flu and SARS scares, and swine flu is no different. Since May, the Food and Drug Administration has warned more than 75 Web sites selling more than 135 products to stop making fraudulent H1N1 influenza virus claims—and they’ve been keeping a list of fraudulent products.

Back in May, we reported on the lack of evidence for most flu supplements. There’s little reason to believe that supplements are effective for preventing or treating any flu. And some, such as colloidal silver, can actually be dangerous.

A new article from the Associated Press reports that "products making bogus claims to prevent or treat swine flu are flooding the Internet as scam artists prey on the public's fears while the vaccine is delayed." Among the scams: air "sterilizers," photon machines, immune boosting supplements, and non-prescription Tamiflu that turned out to be powdered talc and a generic chemical, or even worse, unapproved doses of the drug that could be impure, subpotent, superpotent or contaminated.

"It's harmful, disappointing, frustrating to see folks take advantage of the public like this," our own John Santa, M.D., director of the Consumer Reports Health Ratings Center, told the AP.

—Kevin McCarthy, associate editor

For more on swine flu scam treatments, read our blog "Avoid Supplements Claiming to Help with Swine (or any) Flu".

Q&A: Upright vs. reclining exercise bikes

My gym offers some bikes on which you recline while pedaling. Are those better than the standard kind? —T.B., Chicago

For some people.While the intensity of the workout probably does not vary between the two types of exercise bikes, reclining or semirecumbent bikes may be safer for your muscles and joints. That’s because your lower back and upper body are supported on an angled cushion while you pedal, and this and the semirecumbent’s wider seat provide extra comfort. Consider that type if you have neck, shoulder, back, or hip problems, are overweight, or simply find that the bike’s design makes pedaling easier.

Swine flu vaccine FAQ’s: Is the vaccine safe?

We recently discussed the five most common misconceptions about flu vaccines, and answered questions about who should get the vaccine. Today we answer some common questions about the safety of the vaccine. We’re going to continue to answer your questions, so keep them coming in the comments.0

Q: Isn’t the swine flu vaccine untested and being rushed into use?

A: No. Here at Consumer Reports, we’re often skeptical about new drugs and treatments since they don’t yet have a long track record to establish their safety and effectiveness. But the 2009 H1N1 vaccine isn’t really a new drug, any more than the regular (seasonal) flu vaccine is. That vaccine is made from scratch each year using the strains of influenza virus most likely to circulate in the coming season, and decades of evidence show that it’s quite safe and moderately effective (some years are better than others) at preventing cases of the flu. The H1N1 vaccine is just like the regular vaccine, except it contains the new virus that causes the swine flu. Several clinical trials have shown the vaccine’s effectiveness at preventing H1N1 infection, and they revealed no significant safety problems, according to researchers. Those studies weren’t big enough to rule out rare adverse effects, which usually don’t emerge until a drug or vaccine has hit the market and been used by a large number of people. But there’s no reason to suspect that the swine flu vaccine is any more likely to produce such events than the seasonal flu vaccine. Health officials have put monitoring systems into place that are designed to catch any rare side effects that occur once the vaccine becomes available.

Q: I heard the swine flu vaccine has an untested ingredient called squalene. Is that true?

Study: Smoking bans cut nonsmokers’ heart attack risk

A new report released this week by the Institute of Medicine confirms that smoking bans do indeed reduce the risk of heart attacks and heart disease associated with exposure to secondhand smoke. In addition, the report, based on data from 11 key studies on heart attack rates, confirms that breathing secondhand smoke increases nonsmokers' risk for heart problems. Those studies found that the incidence of heart attacks dropped anywhere from 6 percent to 47 percent after cities, states, or even whole countries like Italy or Scotland banned indoor smoking.

Exposure to secondhand smoke appears to increase the risk of heart disease by about 25 to 30 percent among nonsmokers, the IOM concluded. And in the United States alone, secondhand smoke is estimated to be responsible for approximately 46,000 deaths from heart disease, 3,400 lung cancer deaths, 150,000 to 300,000 lung infections, including pneumonia and bronchitis in children, an increase in the severity of asthma attacks from about 200,000 to 1 million in children with asthma, and more than 750,000 middle ear infections in children.

Back when Consumer Reports investigated the risks associated with secondhand smoke in 1995, the idea that secondhand smoke could cause heart disease was still under debate. At the time, just five states had outlawed smoking in the workplace. Today, 25 states, plus the District of Columbia have such laws, and the connection between secondhand smoke and heart disease is no longer in doubt--thanks in large part to the ability of researchers to track the incidence of heart attacks and heart disease before and after such bans.

Q&A: Cod-liver oil hazard?

Between cod-liver oil capsules and a multivitamin, I get 5,500 international units (IU) per day of vitamin A in the retinol form. Could that be harmful? —M.K., El Segundo, Calif.

Yes. The body gets vitamin A in two forms: from retinol, or "preformed" vitamin A, and from beta-carotene, which the body converts into vitamin A. Over time, a high intake of retinol can cause nervous-system and liver damage and increase the risk of birth defects, hip fractures, and premature death. That’s why men and women should get no more than 3,000 IU or 2,300 IU of retinol a day, respectively. Since the evidence on cod-liver oil is limited—just a few studies suggesting that it may reduce depression and certain risk factors for heart disease—you should probably skip it given its retinol content (about 1,250 IU in a typical gel-cap supplement). And ask your doctor about having your blood tested for excessive levels of the vitamin.

ConFLUsion: How to sort out swine flu facts from fiction

It seems that swine flu has infected YouTube. When I was on the Brian Lehrer Show recently, a caller claiming he was a pediatrician announced that the H1N1 (swine flu) virus was "man-made" and another caller urged me to look into this on YouTube because "college students are all over it...". Dangerous rumors like this outlandish conspiracy theory are causing concern all over the country and may be one reason that our swine flu poll found that 43 percent of Americans are on the fence about getting the vaccine. Other ridiculous notions floating around cyberspace include: "there is no swine flu", "a girl got the swine flu vaccine last month and died an hour later", "and you’ll be fine if you don’t eat bacon".

To clear up the misconceptions and give you the facts, we collected a number of rumors we’ve heard on our blog and elsewhere in the media about the swine flu and the swine flu vaccine:

Rumor: It’s better to build up your own natural immunity than gain immunity from a vaccine.

Fact: That was the top reason almost two thirds of those who were unsure or said they would not get their children vaccinated gave for not getting a flu vaccine last year. But that logic misses the whole point of immunity—avoiding disease. When your body is exposed to a virus, it creates antibodies that help fight the disease, When you’re given the vaccine your body makes antibodies that help prevent the disease. In other words, vaccines produce the same antibodies that an infection does, without the inconvenience and misery of having the illness or its life-threatening complications.

Rumor: I’ve never gotten the flu before.