What a difference a year makes ... or not. We head into 2006 the same way we began 2005: Worried about flu and not enough vaccine.
Last year, the concern was ordinary flu because the United States had only half its usual supply of flu shots. Bird flu creeping across Asia was a vague and distant threat.
This year, bird flu extended its reach, spawning fears that it might mutate into a worldwide super-flu that kills people, not just avians.
Countries scrambled to order an experimental bird flu vaccine and Tamiflu, the lone drug known to work against the germ, but both take achingly long to make and are in short supply. In October, the federal government released a plan to deal with a flu pandemic, relying heavily on low-tech measures like quarantine and travel restrictions.
"Right now the U.S. public should not be worried," because the germ doesn't spread person to person, Drs. William Schaffner and Tom Talbot recently wrote to fellow staffers at Vanderbilt University.
"Until the virus develops this ability, if it ever does, your chances of being infected are virtually zero. Leave worrying about this virus to the infectious disease specialists for now," they advised.
Good health news
Amid the flu fears there actually was a lot of good news this year. Cancer overtook heart disease as the leading cause of death among Americans 85 and under. Why is that good, you ask? Because deaths from both are falling, it's just that those from heart disease have fallen more dramatically.
Two vaccines proved effective against human papilloma virus, or HPV, the leading cause of cervical cancer, a big killer around the world.
New-generation cancer drugs like Avastin and Herceptin, which more precisely target the disease and leave healthy cells alone, also scored big victories in studies on lung and breast cancer patients respectively, notes the American Society of Clinical Oncology in its first annual report on cancer progress.
Five years ago, these drugs were in the "hope" stage but now are in wide use, said Dr. Roy Herbst, a lung cancer expert at the University of Texas M.D. Anderson Cancer Center.
In the future, "the goal is going to be to combine the targeted therapies and leave the chemotherapy and radiation aside," sparing patients the harsh effects of these older treatments, he said.
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Meanwhile, the federal Food and Drug Administration continued to battle allegations that it has been too slow to act against dangerous products, and that political concerns were trumping science.
Despite advisers saying the drug is safe, the FDA has refused to allow over-the-counter sales of Plan B, a "morning after" pill to prevent pregnancy.
A top FDA scientist quit over the dispute, and it held up Lester Crawford's confirmation as FDA commissioner. Two months after winning the job, he abruptly resigned amid questions about ethics and financial reporting. Federal officials are investigating.
Other FDA-related developments:
*More bad news about pain killers. Merck's withdrawal of the popular arthritis medication Vioxx from the market in September 2004 was followed in March by Pfizer's withdrawal of Bextra. Both were tied to increased heart risks. Merck lost the first but won the second of many lawsuits alleging it hid information on Vioxx's dangers, and the third ended in a mistrial after a medical journal said Merck failed to report three deaths in one Vioxx study.
*Over-the-counter medications became suspect, too. Warnings were posted on non-steroidal anti-inflammatory drugs, or NSAIDS, a wide class of pain killers including Motrin, Aleve and Advil. Aspirin wasn't included because studies show that it cuts heart risks rather than increases them.
*Three makers of heart defibrillators issued huge recalls. Guidant Corp. drew criticism for waiting three years to warn doctors and patients about a defect with one model that's been linked to two deaths.
*Silicone-gel breast implants took a step toward returning to market. FDA advisers recommended that one company be allowed to resume selling them but voted against similar plans by another.
*BiDil, the first race-based pill, won approval for blacks with heart failure.
*Natrecor, another heart failure medication, was ordered to carry warnings that it might raise the risk of death.
*Pargluva, a novel Type 2 diabetes drug that had been expected to win government approval, was dealt a blow when a study linked it to higher risk of deaths, heart attacks and strokes.
But the biggest concern about drugs for many people remained how to pay for them. As 2005 drew to a close, seniors struggled to make sense of the complex choices that will give them their first prescription drug benefits under Medicare, starting in 2006.
In other medical news:
*The Terry Schiavo case became a referendum on the right to die as the comatose Florida woman's husband battled her parents to remove a feeding tube keeping her alive. She died last spring after her husband prevailed. An autopsy revealed her brain had stopped working years ago.
*French doctors said they had done the world's first partial face transplant, grafting a nose, mouth and chin from a person who recently died onto a 38-year-old woman mauled by a dog. In the United States, the Cleveland Clinic proceeded with plans to do a full face transplant, interviewing about a dozen potential candidates who were severely burned or disfigured and had exhausted normal reconstructive surgery methods.
*Prostate cancer got big attention. Researchers held the first major scientific conference focused on the disease, which is more deadly to men than breast cancer is to women.
*Research mounted on the benefits of vitamin D, a nutrient the body makes from sunshine. A prominent Harvard doctor made it the topic of his keynote lecture at a major cancer conference, and the American Cancer Society has been reviewing its sunscreen guidelines to see whether modest amounts of sunshine can be termed beneficial.
*Smoking rates continued to decline in the United States. Lung cancer awareness increased with the deaths of newsman Peter Jennings and actress Barbara Bel Geddes, and the diagnosis of the disease in Dana Reeves, a non-smoker.
*Researchers argued about how many deaths obesity really causes, and how bad it is to be overweight. Researchers are keeping an eye on rimonabant, an experimental medication under FDA review that fights overeating in a new way, by blocking a pleasure center in the brain.
*April marked the 50-year anniversary of the Salk polio vaccine.
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