www.charlestondailymail.com Health http://www.charlestondailymail.com Daily Mail feed en-us Copyright 2014, Charleston Newspapers, Charleston, WV Newspapers Report: Doctor wrote bad prescriptions, forced co-worker to 'motor boat' breasts http://www.charlestondailymail.com/article/20140812/DM01/140819739 DM01 http://www.charlestondailymail.com/article/20140812/DM01/140819739 Tue, 12 Aug 2014 20:43:38 -0400 By Dave Boucher

A Martinsburg doctor unethically doled out powerful prescription drugs and repeatedly exposed herself at the office - including forcing a female co-worker to "motor boat" her surgically enlarged breasts - according to allegations in a report from the state Board of Medicine.

A 31-page complaint issued by the board in July accuses Dr. Tressie Montene Duffy of breaking a litany of medical and ethics laws and standards. The board argues Duffy is unqualified to continue practicing medicine.

Duffy, 44, is the CEO and co-owner of West Virginia Weight and Wellness Inc. in Martinsburg. The clinic's website says its doctors focus on weight management, but they also offer primary and urgent care needs and a "Chronic Pain and Opioid Dependency Treatment Program."

Duffy did not return a phone message left Tuesday at the clinic.

Lisa Lilly, Duffy's attorney, said Duffy was familiar with the complaint and "denies any and all wrongdoing." Lilly stressed this is "not the first time" the board has tried to revoke Duffy's license, but declined to elaborate further.

Complaints from at least three different people provide extensive details about Duffy's alleged misconduct dating back to 2010. Former employees identified as "Complainant M" and "Complainant R" and other anonymous sources cited in the report say Duffy's sordid behavior led to many problems.

More than a dozen patients received powerful pain and anxiety medications like Oxycodone, Opana, Valium and Xanax with prescriptions from Duffy filled while she was out of the state on vacation or at a conference, according to the complaint.

Duffy would sign pads of blank prescriptions and tell her office staff - some of whom aren't doctors - to fill them out for patients in her absence, the complaint said.

Duffy - who only accepted direct payments as opposed to billing insurance - said patients had to pay for a doctor visit even when she wasn't in the office if they wanted their medication, the complaint said.

She also allegedly distributed many doses of Suboxone and other controlled substances during years when she was not allowed to do so from her office.

Similar to methadone, Suboxone is a drug that can be used to help wean addicts off of medications but is also easily abused.

Duffy purchased more than 1,000 doses of Suboxone in 2010 and distributed it through 2013, even though she wasn't registered to give out such medications from her office until December of 2013, according to the complaint.

Duffy also reportedly self-prescribed Suboxone and testosterone, although she's never given the board medical records of self-treatment or self-prescribing. In 2013 a board investigator found medications, some surrendered by patients, in a safe at the clinic and labeled for "office use," according to the complaint.

Complainant R also says Duffy, "engaged in a scheme with a drug salesperson to inflate the salesperson's sales in exchange for consideration from the salesperson, including paid parties and office staff."

Her medical license also lapsed from July 1 to Sept. 18, 2012.

Other anonymous complaints accused Duffy of similar charges, in addition to sexual behavior after she underwent breast augmentation surgery. Duffy repeatedly exposed her "post-augmentation breasts" to staff and patients at the clinic, according to the complaint. She also reportedly rubbed them against staff and allowed or permitted drug salespeople to feel her breasts while staff or patients were present.

In early 2012 Duffy allegedly placed her hands on the head of Complainant R.

"Dr. Duffy pulled Complainant R's head between Dr. Duffy's breasts and asked Complainant R to 'motor boat' her," the complaint states.

"Motor boating" is slang for a person moving his or her face back and forth between another person's breasts and making a sound like a boat engine.

"Later that same day, Dr. Duffy grabbed Complainant R by the back of her head and kissed her on the lips," the complaint continues.

Complainant R told Duffy the actions were unwelcome and asked her to stop. Duffy said Complainant R was being a "titty baby," the complaint states.

Complainant R cited the alleged sexual abuse - and Duffy throwing a chair at her - as reasons she quit her job.

Duffy kicked a chair at an employee, verbally abused people and was prone to "temper tantrums," according to the complaint.

The board investigation stems back to at least 2012 and includes the complaints, an audit, an inspection, at least one hearing and subpoenaed documents. In April the board hired a medical doctor licensed in West Virginia to review information obtained during the investigation.

The doctor found Duffy didn't discuss pain medication options with patients, instead telling them to choose their own pain medications, and that many patients received a "prescription concoction" of pain and anxiety medications "without clear documentation of a specific medical justification." The doctor also found patient records were "scant and contradictory."

"The continued licensing of Dr. Duffy to practice medicine and surgery in the State of West Virginia presents a danger to the public due to her violations of the West Virginia Medical Practice Act," the complaint concludes.

The board has taken action against Duffy in the past related to illegal prescriptions.

In 2009 she was charged with felony prescription fraud and conspiracy to commit prescription fraud, according to a Berkeley County court document posted online by the Martinsburg Journal newspaper.

Duffy worked with a local pharmacist to obtain a prescription under another person's name, the report states. After pleading no contest to a misdemeanor charge of insurance fraud Duffy agreed to pay a $500 court fine and other court costs, according to the Herald-Mail newspaper in Hagerstown, Maryland.

The Board of Medicine determined in February 2010 the crime was "the result of a series of extraordinarily poor decisions on the part of Dr. Duffy in her personal life" but not related to patient treatment.

She was publicly reprimanded and agreed to undergo counseling for 18 months.

Duffy hadn't started receiving treatment by late August 2010, resulting in another complaint by the board. In March 2011 she was fined $1,000, again publicly reprimanded and ordered to complete the 18 months of counseling.

Lilly said there are no criminal charges pending against Duffy "that we're aware of."

Duffy first received a license to practice medicine in 1999 after graduating from the West Virginia University School of Medicine. In May WVU noted on its website Duffy was recently honored by two medical organizations.

"Over her 13 years in practice, Dr. Duffy has continued to demonstrate the passion, dedication, and enthusiasm for patient care necessary to be considered a Top Physician in her field," WVU's website states.

Duffy is required to attend a hearing in November if she wants to keep her license. The hearing, scheduled to start Nov. 17, is before a doctor hired by the board as a hearing examiner.

The full board has the right to accept, reject or modify the hearing examiner's findings.

Contact writer Dave Boucher at 304-348-4843 or david.boucher@dailymailwv.com. Follow him at wwww.Twitter.com/Dave_Boucher1.

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Colgate's unseen FDA pages flag consumer concerns http://www.charlestondailymail.com/article/20140812/ARTICLE/140819856 ARTICLE http://www.charlestondailymail.com/article/20140812/ARTICLE/140819856 Tue, 12 Aug 2014 00:01:00 -0400

By TIFFANY KARY

Bloomberg News

NEW YORK - The chemical triclosan has been linked to cancer-cell growth and disrupted development in animals. Regulators are reviewing whether it's safe to put in soap, cutting boards and toys. Consumer companies are phasing it out. Minnesota voted in May to ban it in many products.

At the same time, millions of Americans are putting it in their mouths every day, by way of a top-selling toothpaste that uses the antibacterial chemical to head off gum disease - Colgate-Palmolive Co.'s Total.

Total is safe, Colgate says, citing the rigorous Food and Drug Administration process that led to the toothpaste's 1997 approval as an over-the-counter drug. A closer look at that application process, however, reveals that the some of the scientific findings that Colgate put forward to establish triclosan's safety in toothpaste weren't black and white - and weren't, until this year, available to the public.

Colgate's Total application included 35 pages summarizing toxicology studies on triclosan, which the FDA withheld from view. The agency released the pages earlier this year in response to a lawsuit over a Freedom of Information Act request. Later, following inquiries from Bloomberg News, the FDA put the pages on its website.

The pages show how even with one of the U.S.'s most stringent regulatory processes - FDA approval of a new drug - the government relies on company-backed science to show products are safe and effective. The recently released pages, taken alongside new research on triclosan, raise questions about whether the agency did appropriate due diligence in approving Total 17 years ago, and whether its approval should stand in light of new research, said three scientists who reviewed the pages at Bloomberg News's request.

Among the pages were studies showing fetal bone malformations in mice and rats. Colgate said the findings weren't relevant. Viewed through the prism of today's science, such malformations look more like a signal that triclosan is disrupting the endocrine system and throwing off hormonal functioning, according to the three scientists.

Colgate's application materials also show that the FDA asked questions about the thoroughness of cancer studies, which are partly addressed in recently released documents.

Some questions about triclosan's potential impact on people are, by nature, unanswerable. Humans are exposed to dozens of chemicals that may interact in the body, making it almost impossible to link one substance to one disease, said Thomas Zoeller, a biology professor at the University of Massachusetts Amherst, who specializes in how chemicals affect the endocrine system.

"We have created a system where we are testing these chemicals out on the human population. I love the idea they are all safe," Zoeller said. "But when we have studies on animals that suggest otherwise, I think we're taking a huge risk."

New York-based Colgate isn't accused of wrongdoing, and the 35 pages don't prove triclosan is harmful. It was the FDA's decision to keep the documents off of its website, Colgate said.

The FDA followed standard procedure by redacting information that had come from a third party, said spokeswoman Andrea Fischer. Some studies were done in the labs of Ciba- Geigy, the first triclosan maker and a predecessor to its current primary maker, BASF SE, according to the documents. The pages didn't denote which studies were done by an outside party, or who the party was. Fischer declined to identify them.

Colgate said Total's effectiveness and safety are supported by more than 80 clinical studies involving 19,000 people, and that it gave the FDA 98 volumes, numbering hundreds of pages each, in support of Total. Colgate submits annual reports to the FDA reviewing new science and safety findings, said Colgate spokesman Thomas DiPiazza.

"In the nearly 18 years that Colgate Total has been on the market in the U.S., there has been no signal of a safety issue from adverse-event reports," DiPiazza said. Colgate also pointed to an independent 2013 review by the Cochrane Oral Health Group, a network of doctors, researchers and health advocates, which found no evidence of harmful effects associated with using Colgate Total.

Total has an important health benefit because it fights plaque and gingivitis, DiPiazza said. Gingivitis can progress to periodontal disease, which affects almost half of Americans 30 and over, according to a 2012 study by the Centers for Disease Control and Prevention.

The FDA reviews all new safety information on ingredients to determine whether a reassessment is necessary, said Jeff Ventura, a spokesman. The agency is revisiting triclosan in hand soaps though not in Total, said Sandra Kweder, deputy director of the agency's Office of New Drugs. That's because while triclosan hasn't been proven superior to soap and water at washing hands, she said, its benefit as an active ingredient in toothpaste was made clear through its FDA approval process.

Colgate removed triclosan from its Softsoap liquid handsoaps and Palmolive antibacterial dish liquid in 2011, citing changing consumer preferences and superior formulations. It said it has no plans to reformulate Total, which is the only triclosan toothpaste approved for U.S. sale.

This article is based on interviews with Colgate, former and current FDA staff and oral biology experts, transcripts of FDA meetings, as well as on the 35 pages, which the FDA shared in January with the Natural Resources Defense Council, a public-health advocate that sued for them. The scientists who examined the pages included Zoeller, a second university- affiliated endocrine specialist, and an environmental toxicologist affiliated with the Environmental Working Group, a public health advocacy.

Of the more than 84,000 chemicals sold in the U.S., few are attracting more scrutiny than triclosan. Used for decades in handsoaps, it is now part of almost 200 products including rugs and pet-food dispensers. Companies including Johnson & Johnson and Procter & Gamble Co. have vowed to remove it from their lineups. In May, Avon Products Inc. announced its plans to go triclosan-free.

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Bioengineers create most realistic fake brain tissue to date http://www.charlestondailymail.com/article/20140811/ARTICLE/140819859 ARTICLE http://www.charlestondailymail.com/article/20140811/ARTICLE/140819859 Mon, 11 Aug 2014 18:59:22 -0400

By RACHEL FELTMAN

The Washington Post

Bioengineers have created the most realistic fake brain tissue ever - and it's built like a jelly doughnut. The 3D tissue, described in a paper published Monday in PNAS, is so structurally similar to a real rat brain (a common substitute for human brains in the lab) that it could help scientists answer longstanding questions about brain injuries and disease.

Currently, the best way to study brain tissue is to grow neurons in a petri dish. But while these neurons can only be grown flat, a real brain contains a complicated structure of 3D tissue. Simply giving the neurons room to grow in three dimensions didn't prove successful: While neurons will grow into more complicated structures in the right kind of gel, they don't survive very long or mimic the structure of a real brain.

Led by David Kaplan, the director of the Tissue Engineering Resource Center at Tufts University, researchers developed a new combination of materials to mimic the gray and white matter of the brain. The new model relies on a doughnut-shaped, spongy scaffold made of silk proteins with a collagen-based gel at the center.

The outer scaffold layer, which is filled with rat neurons, acts as the gray matter of the brain. As the neurons grew networks throughout the scaffold, they sent branches out across the gel-filled center to connect with neurons on the other side. And that configuration is about as brain-like as lab-grown tissue can get. The basic structure can be reconfigured, too.

By creating a model with six concentric rings, each populated with different types of neurons, the researchers were able to mimic the six layers of a human brain cortex. "It's a form-fitting, Lego-like system, so we don't have to worry about using glues, and how they might complicate the interfaces between these different compartments," Kaplan said.

In the PNAS paper, Kaplan and his colleagues report that the tissue can already survive for months at a time in the lab. They've used it to study the effect of traumatic brain injury on neuron activity (by dropping weights onto the tissue) immediately, instead of having to dissect a brain.

"This is a very tunable way to construct a brain-like tissue with both the structure and function of a brain," Kaplan said. And the Lego-block nature of the design means that researchers can manipulate it into the kinds of brain structures they want to study. "It could help us answer questions about neurological diseases like Alzheimer's," Kaplan said. And the model could be used to study the effects of the drugs used to treat brain-related ailments, like depression and epilepsy. Often, Kaplan said, the actual mechanisms of these vital drugs are a mystery.

But a good model of the brain could probe into deeper questions, too. "There are questions we have that are more difficult to define, like how we store memories or how the brain feels pain," Kaplan said. "It's a long list of questions to answer, which is why we're so excited."

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New app helps people navigate health care system http://www.charlestondailymail.com/article/20140811/DM05/140819920 DM05 http://www.charlestondailymail.com/article/20140811/DM05/140819920 Mon, 11 Aug 2014 00:01:00 -0400 By Josephine Mendez A new app created by UnitedHealthcare will help the public understand how to better navigate the health care system.

The app, Health4Me, was launched in 2012 for UnitedHealthcare members only, but a new guest version recently was released to all iPhone and Android users.

With the guest version, users can find the closest urgent care facility or ER, as well as search for doctors by specialty and location.

Will Shanley, a spokesman for UnitedHealthcare, said the app is convenient and very easy to use.

"The app is great when you are traveling and need to find the closest hospital or urgent care," Shanley said. "It's also helpful if you are new to a city and you need to find a pediatrician or any type of health care provider."

A price transparency feature within the guest version of the app allows people to review the market average prices for more than 520 common medical services.

The app also shows the user a breakdown of what patients can expect throughout the course of a specific treatment.

"It shows you step-by-step and makes it so people can really understand and anticipate what their medical services will entail," Shanley said.

The app is customized to individuals' health plans and takes into account their current deductibles and co-pays. Members also can view the contracted rates for various providers and facilities.

"Say you need a knee MRI," Shanley said. "You can go in and find out how much it would cost one facility versus another facility. It is so very useful because there is a tremendous price variation for medical services - jaw droppingly so. In some cases, it can be many times more expensive in the same market."

With the app, consumers can have more control of their health benefits.

"No one would go and buy a TV without doing a little bit of comparison shopping, but health care has historically been different," Shanley said. "Hopefully with the app we can change that."

Additional features for the members' version include a digital health care ID card, access to a registered nurse 24/7 and access to personal health records.

The app has been downloaded by 900,000 UnitedHealthcare members. According to a survey, 84 percent of the users said they would use it again and 67 percent said the tool gave them confidence to make better health care choices.

"People are very mobile; people are traveling and need this information when and where they are at," Shanley said.

Health4Me can be downloaded as a free app from the Apple iTunes App Store for the iPhone, iPod Touch and iPad. It can also be downloaded for Android phones in the Android marketplace.

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Medicaid commissioner on 'extended leave' http://www.charlestondailymail.com/article/20140810/DM01/140819956 DM01 http://www.charlestondailymail.com/article/20140810/DM01/140819956 Sun, 10 Aug 2014 14:42:23 -0400 By Dave Boucher Nancy Atkins, head of the state's Medicaid program, is on "extended leave," said Department of Health and Human Resources spokeswoman Allison Adler.

Adler declined to say why Atkins is on leave from her position as commissioner of the Bureau for Medical Services, how long she's been on leave or whether Atkins is still getting paid while she's on leave.

"I can't comment on the specifics of Commissioner Atkins' leave as that is part of her personnel file," Adler said.

Atkins could not be reached by the Daily Mail for comment.

Cindy Beane was appointed "acting commissioner" by DHHR Secretary Karen Bowling on Aug. 4, Adler said. Beane was deputy commissioner of policy coordination for the bureau before taking on the new role.

However, Jeremiah Samples, a deputy secretary for the DHHR, "handled the administrative duties of the commissioner" for three weeks before Beane was appointed, Adler said.

Beane recently received a 5 percent pay increase, said Audrey Pennington, executive assistant with the state Department of Revenue. She now earns $67,464 compared to the $64,248 salary she received before the change in duties.

Atkins' salary has not changed since July 1, when every state employee received a $504 raise, Pennington said. She did not know what Atkins' salary was after the raise.

Atkins' salary is $94,404, Adler said. As of 2013, Atkins earned $109,440 in "total compensation," according to the state auditor's website. Justin Southern, spokesman for the auditor's office, referred any comment about salary changes to the Department of Revenue.

Then-Gov. Bob Wise appointed her commissioner of the bureau in 2001 and then-Gov. Joe Manchin reappointed her in 2005, according to a 2007 resolution adopted by the state Senate. While that resolution says Atkins "has decided that her talents, leadership and knowledge base can better serve West Virginia by moving into the private sector," she returned to the position in 2009, according to the Associated Press.

West Virginia and Atkins' bureau recently received recognition for the enrollment of more than 130,000 new people in the Medicaid system in accordance with provisions of the federal Affordable Care Act, also known as Obamacare.

Contact writer Dave Boucher at 304-348-4843 or david.boucher@dailymailwv.com. Follow him at www.Twitter.com/Dave_Boucher1.

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Task force offers free 'WVHelp' app http://www.charlestondailymail.com/article/20140808/ARTICLE/140809361 ARTICLE http://www.charlestondailymail.com/article/20140808/ARTICLE/140809361 Fri, 8 Aug 2014 09:21:57 -0400 CHARLESTON, W.Va. (AP) - A West Virginia app is now available to help those who are being abused or maltreated, particularly children.

The "WVHelp" app has been rolled out by the West Virginia Children's Justice Task Force. The app is free.

The app is designed to quickly locate and contact resources throughout the state that deal with young victims of abuse. Information on the app can be found at http://go.wv.gov/wvhelp.

The application provides phone numbers, addresses and fax numbers for county law enforcement, prosecutors, sheriff's departments, medical facilities, domestic violence programs, sexual assault programs, and more in each of West Virginia's 55 counties.

The application also provides contact information for key resources at both the state and federal levels.

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Feds describe new W.Va. chemical spill studies http://www.charlestondailymail.com/article/20140808/ARTICLE/140809363 ARTICLE http://www.charlestondailymail.com/article/20140808/ARTICLE/140809363 Fri, 8 Aug 2014 09:20:30 -0400 CHARLESTON, W.Va. (AP) - Federal health officials are outlining new studies on the chemicals that spilled into West Virginia's largest drinking water supply.

The National Toxicology Program said in a Thursday memo that potential pregnancy and liver complications are among study topics.

One study will see if pregnant rats exposed to MCHM show birth defects or health issues in their offspring.

Another will see how the chemicals affect zebrafish and roundworms over their entire lifespans.

Researchers will also look at more subtle short-term changes to gene expression in rats' livers from the chemicals.

They will keep using computer modeling to predict harmful effects of the chemicals.

Study results should be available within a year.

The January spill at Freedom Industries contaminated 300,000 people's water for days.

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Groups rally against mine permit http://www.charlestondailymail.com/article/20140807/DM01/140809386 DM01 http://www.charlestondailymail.com/article/20140807/DM01/140809386 Thu, 7 Aug 2014 21:21:57 -0400 By Matt Murphy Loudendale resident Daile Boulis said the value of her home on Middlelick Branch plummeted to half its value after the permit for the KD No. 2 mountaintop removal mine was approved in May.

After blasting began earlier this summer to prepare the hilltop above her property to be cut off, Boulis said her home's value dropped further - to 20 percent of its pre-permit value.

And when Boulis and her husband - admittedly naively - went to the state Department of Environmental Protection for help, they found no assistance.

"I had no idea they weren't really there for us," Boulis told a crowd of about 100 gathered at the state Capitol Thursday night. "They're there for the coal companies, and that makes me sad."

In May, the DEP approved a permit for a mountaintop removal mine on a hill next to Kanawha State Forest - the only state park in about an hour's drive of Charleston - and the residential community of Loudendale.

As the permit was approved, the Kanawha Forest Coalition was established in response to the permit and is made up of a variety of interested parties, many of which were represented at Thursday's rally, including hikers, cyclists, gun owners, runners, hunters, affected Loudendale residents and others who want to show support for Kanawha State Forest.

The group has been fighting the permit and circulating a petition asking Gov. Earl Ray Tomblin to revoke the permit.

The coalition plans to deliver the signatures - estimated to be in the thousands - to the governor at 1 p.m. today.

Meanwhile, a hearing about the permit is scheduled before the West Virginia Surface Mine Board on Monday beginning at 8:30 a.m.

The DEP said in a press release Thursday the hearing is expected to last most of the day and will be livestreamed online.

Residents like Boulis are hoping the permit will be reversed.

Besides property values, Boulis is also concerned about her well water, which she particularly valued after the Jan. 9 chemical leak that contaminated drinking water for West Virginia American Water customers in the Kanawha Valley.

Boulis said she also has problems with how the mine's permit application was handled. She said she didn't know the permit was even being considered until after it was approved, and said she was never notified about a public hearing last fall at Riverside High School - a 20 mile, half-hour drive from the state forest's northern entrance.

"It's just one thing after another that, at least for me, doesn't add up," she said.

Despite the problems, Boulis said the community support behind the fight against the mine has been encouraging.

"I don't feel like I'm fighting alone, and that's awesome," she said.

Kanawha Forest Coalition organizer Chad Cordell said the coalition has also found discrepancies with the mine's permit.

One of the latest contentions is that the permit did not receive approval by the State Historic Preservation Office, which the coalition and Keeper of the Mountains Foundation believes is necessary because some infrastructure in the state forest is listed on the National Register of Historic Places, according to a Gazette-Mail article last month.

"We are here because Governor Tomblin and the Department of Environmental Protection have failed us," Cordell told the crowd Thursday night.

One group, the Kanawha Trail Club, has property near the state forest on Middlelick Branch. Trail club representative Kathy Hastings said having blast warning signs on trails at the state forest - placed earlier this summer - take aim at the 72-year-old club's mission.

"If we have blasting notices on our trails, that doesn't encourage hiking," she said.

Jim Waggy, representing a birding group, discussed the effect the mine would have on that aspect of the park.

"It deserves our protection," he said of the state forest.

Cordell's daughter, Ukiah, said she's grown up with the forest and has valued the experiences she's had in the park.

"I hope that everyone who cares about Kanawha State Forest and doesn't want their water to be dirty and doesn't want their air polluted helps as much as they can," she said.

The DEP said Monday's hearing can be viewed at https://www.youtube.com/user/WVEnvironment or at https://plus.google.com/110674270939790188292/posts.

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Health official says doctors 'shouldn't make distinction' between mandatory and optional shots http://www.charlestondailymail.com/article/20140806/DM01/140809497 DM01 http://www.charlestondailymail.com/article/20140806/DM01/140809497 Wed, 6 Aug 2014 20:34:09 -0400 By Samuel Speciale As parents take their preteen children to get back-to-school shots this week, they likely will be given an option to receive additional vaccinations recommended by health officials but not required for school entry.

If their doctor follows the suggested language of a call-to-action issued last month by 13 local and state health organizations, they could be left with the impression that certain vaccinations, like the one for the sexually transmitted human papillomavirus (HPV), are now mandatory for school attendance.

In the call-to-action, doctors are urged to recommend the controversial HPV vaccination to parents and their preteen children by removing the distinction between the optional shot and those required to attend school.

When asked if doctors are being asked to follow a script that equates mandatory and optional vaccinations, Jeff Necuzzi, director of immunization services for the West Virginia Bureau for Public Health, said the call-to-action only makes a suggestion.

"We're just trying to reinforce that providers need to strengthen their message when discussing vaccinations," he said. "They (doctors) shouldn't make a distinction that some are mandatory and one isn't."

But there is a clear distinction between mandatory and optional vaccinations, and it all has to do with the communicability of the disease they inoculate against.

All students entering seventh grade, the recommended age for starting the HPV vaccine series, are required to get a dose of the meningococcal vaccine and a booster for diphtheria, tetanus and whooping cough. Each are highly contagious and can be spread by casual contact or by air.

"The reason for requiring one vaccination isn't based on its importance or effectiveness," Necuzzi said, later adding that the HPV vaccine isn't required simply because it's not as easily transmitted.

Still, certain strains of HPV are often linked to deadly cancers, and because most of the adult population is already infected or will eventually contract the virus, health officials are prompted to find ways to improve low vaccination rates. About 45 percent of girls in West Virginia start the three-dose series with only 36 completing. It's even lower among boys.

This has led officials to target the way doctors communicate with their patients.

Studies have shown that parents are four to five times more likely to consent to their children getting a vaccination when it is strongly recommended by their doctor.

Candace Nunley, manager of clinical operations for the Kanawha-Charleston Health Department, said communication is key because many parents aren't educated about most vaccines, especially HPV.

"They think it's not necessary because their children aren't sexually active," she said. "But, we have to educate parents on the importance of getting it."

Because HPV is a sexually transmitted infection, the vaccination is often opposed because some believe it will encourage teens to start having sex. Necuzzi said anyone who thinks that way should be ashamed.

"We are frustrated that anyone is suggesting there is a correlation," Necuzzi said. "It has nothing to do with it. It prevents cancer."

While the vaccine is well-supported by the Centers for Disease Control and other health organizations, Necuzzi doesn't expect to see it become mandatory in West Virginia because there has been political backlash in states that require it for school attendance.

In 2007, a year after the Food and Drug Administration approved Gardasil, the most common HPV vaccine brand, Gov. Rick Perry bypassed the Texas Legislature by issuing an executive order that made the state the first to mandate the vaccine for 11- and 12-year-old girls.

Initially, it was not a popular decision. The controversy grew when it was found that members of Perry's administration were linked to lobbying groups for Merck & Co. Inc., the pharmaceutical company that manufactures Gardasil.

It was also found that Perry received $31,000 from Merck between 2001 and 2012, the most of any political candidate in the country.

The Texas Legislature later overturned Perry's order.

In addition to the Texas controversy, Merck came under fire in the early 2000s for lobbying state Legislatures to make Gardasil vaccinations mandatory for girls to attend school.

The company has since abandoned that tactic, but still retains three lobbyists in West Virginia, where more than 300 political contributions were made between 2001 and 2012 for a total of $147,700, good for the tenth most in the country.

HPV vaccines cost $125 to $200 per dose, making the series as expensive as $600. While some insurance providers do not cover the cost of the vaccine, most children can get the shot at no cost thanks to state programs and new requirements of the Affordable Care Act.

When asked if she thought equating the costly HPV vaccines with those that are mandatory is at all misleading or could cause the public to further distrust vaccinations, Nunley said she didn't think that was the case.

While anti-vaccination groups are on the rise, Necuzzi said he is only concerned with maintaining public confidence in vaccines and the HPV program in general.

"We have high hopes the approach we are taking will help us reach our goals."

Contact writer Samuel Speciale at sam.speciale@dailymailwv.com or 304-348-4886. Follow him at www.twitter.com/wvschools.

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Thomas Memorial adds room for breastfeeding employees http://www.charlestondailymail.com/article/20140806/DM01/140809532 DM01 http://www.charlestondailymail.com/article/20140806/DM01/140809532 Wed, 6 Aug 2014 16:59:34 -0400 By Charlotte Ferrell Smith The Nursing Nook at Thomas Memorial Hospital is a cozy, comfortable room where breastfeeding employees can take a break from work to pump milk for their babies.

A ribbon cutting was held on Wednesday at the South Charleston hospital where administrators and employees gathered to celebrate the opening of the Nursing Nook in conjunction with World Breastfeeding Week.

Stephani Sink, a registered nurse at the hospital, stopped by with her 2-year-old daughter, Avery. She is expecting a son in eight weeks.

"I'm excited," said Sink, 34. "I will be able to pump somewhere private. In the NICU (neonatal intensive care unit) I can pull a curtain but families are around and it's very distracting. It's hard to get away when you are in there. People ask you things and you feel rushed because everybody is so busy."

The former patient room turned Nursing Nook will be the perfect getaway for mothers who wish to pump in a relaxed atmosphere. The 10-by-8 foot room has a recliner with a nearby table filled with supplies such as bottles, nursing pads, wipes, and storage bags. There is a television and a private restroom. A Medela Symphony, a $1,200 machine, is available for pumping. Employees connect their personal kits to the machine for collecting breast milk.

"Right now we have close to a dozen employees who are breastfeeding," said Jamie Peden, registered nurse and international board certified lactation consultant. "Most are nurses."

She said research shows that the number of breastfeeding mothers is on the rise as more people are educated on the pluses for mother and child.

"The longer a mother nurses, the better the health benefits for her and the baby," Peden said. "Most moms go back to work at six weeks which is not nearly enough time for breastfeeding. Breast milk is made for the baby's gut."

She said an infant should receive nutrition exclusively from breast milk for the first six months. Solids are then introduced to the baby while breastfeeding should continue for the first full year, she said.

"After that it is whatever is mutually acceptable to mom and baby," she said.

Research shows babies who receive only breast milk for the first six months of life are less likely to develop a wide range of chronic and acute diseases, including ear infections, diarrheal diseases, asthma, obesity, and respiratory illness. Mothers also benefit with a decreased risk for breast and ovarian cancer.

"A mom who breastfeeds has less depression and fatigue" she said. "Sleep increases" as a soothing bond is created between baby and mother.

She said breastfeeding is a new skill that can be achieved with education and community support.

"Without community support, it is hard," she said. "We can help."

Breastfeeding is included in the Childbirth Education Class offered 9 a.m. to 3 p.m. the third Saturday of every month in the Education Classroom at Thomas Memorial Hospital, 4605 MacCorkle S.W. in South Charleston. Cost of the all-day class is $60 per couple, including breakfast and lunch. Call 304-766-3971 to register. The next class is set for Aug. 16.

Peden suggests several links for acquiring information about everything from breastfeeding and laws to insurance coverage. Go to http://www.dol.gov/whd/nursingmothers/ or http:www.dol.gov/whd/regs/compliance/whdfs73.htm or http://www.hrsa.gov/womensguidelines/ for more information.

Peden said breastfeeding mothers are always welcome to call her for free information and guidance.

"Lactation services are free for everyone," Peden said.

The telephone number is 304-766-3838.

Contact writer Charlotte Ferrell Smith at charlotte@dailymailwv.com or 304-348-1246.

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Coalition awards $80,000 to communities http://www.charlestondailymail.com/article/20140803/DM01/140809813 DM01 http://www.charlestondailymail.com/article/20140803/DM01/140809813 Sun, 3 Aug 2014 19:23:17 -0400 By Whitney Burdette A statewide coalition to promote healthy lifestyles has awarded thousands of dollars in grants to 20 groups - double the amount anticipated.

Try This, part of the Our Children, Our Future campaign, gave the money to help projects such as bicycling clubs, hiking trails and fitness classes that aim to build healthier communities. In all, 42 grants were awarded, totaling $80,000.

"These teams are proving you don't need a lot of money to start a creative project that makes your community a healthier place," said Stephen Smith, Try This co-chairman.

Representatives from the 42 projects attended the Try This conference in June. There, they had the opportunity to network and learn how to write grants. Teams were challenged to develop solid projects they could implement for $3,000 or less. Those ideas further generated buzz within the local community.

"The Hendricks town council members have been around awhile, but when they heard we got our grant, they got excited and started talking about ways to get gravel and wheelbarrows and other things we could do," said April Miller of the Tucker County Family Resource Center.

A coalition of 20 statewide public and private groups have teamed up to support the Try This initiative and fund the grants. Projects include everything from playgrounds to community gardens to food pantries. A project in Jackson County will survey trails in the area, create a trail guide and promote hiking.

"We can do a lot with a little," said Wendy Crawford, a public health nurse and Jackson's team leader. "If we get just a little bit for each project, we'll make it happen. When you hear so many resources and ideas and you have people to help you, you just want to add another project and another project."

In the month following the conference, several more community groups have formed, such as the Lewis County Wellness Council, Mt. Hope on the Move and Try This Monongalia County. Each team already has started several projects.

The Logan team, which is reviving basketball teams and gardening in the area, has asked the Logan County Chamber of Commerce to match its grant.

"It's incredible to see such a diverse group of people, including young people, coming together to make a healthier community," said team leader Lida Shepherd.

A full list of projects and ideas for future projects is listed at www.trythiswv.com.

Contact writer Whitney Burdette at 304-348-7939 or whitney.burdette@dailymailwv.com. Follow her at www.Twitter.com/wburdette_DM.

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Elk River chemical spill causes ripple effect in rafting industry http://www.charlestondailymail.com/article/20140731/ARTICLE/140739794 ARTICLE http://www.charlestondailymail.com/article/20140731/ARTICLE/140739794 Thu, 31 Jul 2014 21:35:49 -0400 Many worried about chemical leak impact after slow summer season

By TODD C. FRANKEL

THE WASHINGTON POST

FAYETTEVILLE - Dave Arnold stares at the giant whiteboard, searching for clues that his slow summer may finally be picking up, lifting like the New River Gorge's morning fog.

The whiteboard hangs inside the storefront of a local photo studio. It lists every commercial whitewater rafting trip for the coming week on the New and Gauley rivers. Every Sunday night, the studio owner's wife grabs a dry-erase marker and climbs a stool to update the data. Photographers use it to schedule shoots of rafters. The rafting companies use it as a vital economic snapshot. They anticipate its arrival like stock traders waiting on the latest corporate earnings. And so every Monday morning, like this one, they gather here, in a narrow hallway in the center of town, to study the signs.

In an instant, Arnold can see how his company, Adventures on the Gorge, and the six other rafting outfitters are measuring up.

"It's a hair slow," he says now. "I'm positive some of it is linked to the spill."

The spill. In January, 10,000 gallons of a chemical used in the mining industry poured into the Elk River in Charleston, 60 miles away, a toxic mess that never reached the waters here, but one that Arnold and others believe hurt business, just the same.

"My whole life has been about selling West Virginia," he said. "Never before have we seen an event that caused so many negative reactions."

The spill is the latest challenge for rafting companies on the New and Gauley rivers, where world-class rapids twist between stunning, tree-covered mountains just five hours from Washington, D.C., and a bit less from Cincinnati. They already contend with long-term declines in outdoor recreation and a tourism sector battered by the recession. The number of rafters here has dropped nearly 50 percent in the past decade, to 112,737 in 2013.

That decline illustrates an ongoing battle over economic diversification in West Virginia, where the tourism industry at times collides with a powerful mining industry that for decades has provided the majority of the state's identity and its good-paying jobs. Tourism is increasingly important to West Virginia, contributing $2.1 billion a year to the state's GDP, just behind chemical manufacturing, according to one state study. Yet that's still less than a third of what comes from the mining and timber industries.

Both tourism and mining use West Virginia's natural gifts, just in very different ways. And the New River Gorge area has served both masters, transformed from an area mined for its coal seams to a place treasured for its rocks and water as they are, its turn-of-the-20th-century coal camps swallowed by nature.

It was on Jan. 9 that a liquid called 4-methylcyclohexane methanol spilled from a storage tank perched on the banks of the Elk River. MCHM, which is used to clean coal, flowed into a water treatment plant that serves 300,000 people, about 16 percent of the state's population.

It was a disaster of unknowns. Officials knew little about the risks of MCHM. Residents were told to avoid tap water. Don't drink it. Don't wash or bathe in it. Not that anyone wanted to: The water smelled like licorice. Schools and restaurants were shut down. Hundreds of people were sickened. Complaints included rashes, headaches and nausea. Today, with the immediate crisis past and officials deeming the water safe, some residents still rely on bottled water.

Not a trace of MCHM flowed into the New or Gauley rivers, which sit well upstream of the spill.

"Water doesn't flow uphill, especially in a mountainous area," Arnold said flatly.

But tourism is built on perception. And Arnold believes West Virginia's image as a "wild, wonderful" destination, a slogan stamped on state license plates, was damaged. Shortly after the spill, he sent an email to his company's largest mailing list to reassure customers that the New and Gauley rivers were unaffected. Online, the company deployed the slogan "H2O-AOK."

State officials worried, too. In March, the state commissioned a poll of the spill's effect on leisure travel. The news seemed good. Only 31 percent of people out-of-state recalled the leak when asked about recent news involving the state. The state tourism commission kicked in an extra $1.2 million for a spring marketing campaign just to be safe, said Amy Goodwin, who recently took over as state tourism commissioner. She said she has not seen signs the incident hurt tourism.

"I think we were fearful it would have a greater impact than it did," she said.

But many in the tourism industry zoomed in on a less-discussed finding of the same poll: 7 percent of respondents said the leak had a strong negative impact on their likelihood of a state visit.

Standing before the whiteboard, Arnold recalled the figure.

"What, are you kidding me?" he said. "Seven percent is huge!"

Next to him, Adventures CEO Dave Hartvigsen nodded. He was taking notes in a black notebook. Hart, as he's called, did the math: 7 percent of tourism's estimated $5 billion economic impact on the state.

"That's $350 million," Hart said. "Somewhere in a consumer's mind it was placed - I don't want to go to West Virginia."

Hart joined Adventures in October from Xanterra Parks & Resorts, a company outside Denver best known for running concessions at national parks. His hiring shows how the rafting business has evolved. Arnold, now 60, had been a kid from Ohio who didn't want to go to med school and so helped start a rafting company in 1978. He didn't know anything about running a business. Back then, more than 30 rafting outfitters ran the rivers, many of them operated by amateurs who just loved to be outside.

Tough times winnowed the competition. Outfitters merged or ran out of money. Today, just seven outfitters run the rivers. The business model has changed. Some of the companies that once were solely rafting outfitters now provide lodging, restaurants and a host of other outdoor activities, such as zip lines and hiking tours. In fact, don't call them rafting outfitters. They are resorts. Adventure resorts.

The change is happening across the country, said Dave Brown, executive director of America Outdoors Association.

"Diversification is the key to success in this industry now," he said.

Today, two companies, Adventures and Ace Adventure Resort, dominate the New River Gorge. They combined to provide nearly 80 percent of the rides down the rivers in 2013. Eleven years earlier, their share was only 28 percent.

Adventures, or AOTG, was created with the mergers of three outfitters. Today, it employs 700 people, including 200 year-round. It has almost 190 big rafts. It has expanded from eight rental cabins in 2008 to 100 cabins today, including some that offer spectacular views along the gorge's rim 800 feet above the New River. Those go for $1,200 a night.

Rafting gave Fayetteville a second chance. A town of fewer than 3,000 residents avoided the faded-glory fate of many former coal-mining towns tucked into the hills of southern West Virginia. Fayetteville has the homey Cathedral Cafe and Gumbo's, a Cajun eatery that bills itself as the only one in the state. It has two bicycle shops. It is home to the original Pies & Pints, a popular place for pizza. A metal street sign hints at how residents think of their town's place in the world: It lists the distance in kilometers to outdoor hotspots in Moab, Yosemite and Africa's Zambezi.

"This place is magic," said Maura Kistler, co-owner of Water Stone Outdoors, an eclectic store that features entire walls of metal carbineers and climbing shoes. She came here with her husband from Virginia more than 20 years ago. They couldn't leave.

But the chemical leak worried her. A couple years ago, many town residents fought to stop a mountaintop removal mining site from opening just four miles away. She wondered if tourism and the state's natural beauty gets the protection it deserves.

"It's truly a dance you do to get progress in your community without pissing off everyone," she said.

At Cathedral Cafe, owner Wendy Bayes - another transplant - said her business was good, but she's heard other business owners, sitting at tables under the banner "Feeding your mind, body and soul," grumbling about their numbers.

The cafe sits next to the photo studio. That's where Arnold and Hart delved into the whiteboard's numbers.

"Love all that color," Hart said, pointing to how the trips were no longer bunched up on the weekends.

"This is what we want," Arnold added. "The guides are happy. The photographers are happy. We're happy."

But the board didn't display what was on Hart's mind. Two months before the chemical leak, Adventure's traffic had been up year-over-year.

"Sixty days after the water crisis," he said, "we were the same amount behind."

Teasing out a single cause for the slowdown is impossible. Maybe it was the harsh winter that caused utility bills to spike and school snow days to accumulate, leaving less money and time for vacations.

"I can't measure it," Jerry Cook, president of Ace Adventure Resort, said of the spill's impact. "But I think it's one more reason to not come here."

It all sounds like another reaction attributed to the chemical spill: widespread itching. People in Charleston would scratch and wonder if that was a regular itch or a sign of toxic exposure.

Arnold recalled visiting Charleston a few weeks after the spill. People were still wary of the water, despite public assurances the water supply had been flushed clean. In his hotel room, Arnold stared at his shower head, silently debating whether to take a shower. Finally, he jumped in.

"The whole day I was itching," he recalled. "Was it real? Was it my head? It was like I'd been rolling around in poison ivy."

He felt the same way about the spill's effect on rafting. Business was down a bit. Was the spill to blame?

"When you're talking about the water thing in West Virginia," Hart added, "it just adds to your quiver of arrows of negative impressions."

Up on the whiteboard, Adventure's final rafting trip Monday was set to depart at 1 p.m.

Twenty people would be shooting down the lower New River on three yellow rafts. They came from Illinois, Florida, Maryland and Arizona. Only a handful of them had heard about the chemical leak. They had put aside any second thoughts about making the trip.

Andy Lockwood was one of the rafting guides. He also works as a mining geologist, consulting with oil, gas and coal companies. But he works the rivers as often as he can. He's been doing it 36 years.

With a trim beard and Hawaiian shirt, the 58-year-old Lockwood is one of those rare people straddling two different visions of the state, one represented by the "wild, wonderful" tourism line and the industrial one that still brings in the bulk of state tax revenues.

Going down the river, he sat at the back of the raft and used his long paddle to navigate past boulders in the churning waters. During lulls, he pointed to spots in the mountainsides where trees sat just a little lower, the canopy showing a slightly different shade of green. Those used to be busy coal camps, he said. A crumbling stone facade, that was a company store. He pointed to a narrow strip of beach made of pebbles and loose coal chunks. Coal once dominated the gorge. Now, it is tourism.

Lately, Lockwood has had more and more time to go rafting. Coal mining is on the decline in West Virginia. Natural gas is the new energy king. He worries he might have to move upstate to be closer to the gas fields. That's where the action is.

"Hate to say it," he said later, off the river, "but I might be the last generation of coal geologists."

But he hopes to keep his job guiding rafts down the New and Gauley.

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Coal dust limit to try to combat black lung http://www.charlestondailymail.com/article/20140731/DM01/140739840 DM01 http://www.charlestondailymail.com/article/20140731/DM01/140739840 Thu, 31 Jul 2014 16:43:10 -0400

By JONATHAN MATTISE

and FREDERIC J. FROMMER

THE Associated Press

CHARLESTON, W.Va. - The Obama administration's push to reduce black lung disease by limiting coal dust in mines will begin to take effect on Friday.

The U.S. Department of Labor's Mine Safety and Health Administration coal dust rule will be phased in, with requirements including increased dust sampling in mines and citations when coal operators don't take immediate action for high levels.

In February 2016, better monitoring equipment will be required. In August 2016, the allowable concentration of coal dust will drop.

Ohio-based Murray Energy and the National Mining Association sued separately over the rule, which was finalized in April.

According to the National Institute for Occupational Safety and Health, black lung has killed more than 76,000 miners since 1968.

It is an irreversible and potentially deadly disease caused by coal dust exposure, where particles accumulate in the lungs.

"I believe it's time for the industry to come to terms that we need to rid the industry of this disease," said Joe Main, assistant secretary of labor for Mine Safety and Health, in a telephone interview with The Associated Press. "It is preventable, but not curable. And it's putting these measures in place on a daily basis to make sure these miners have these protections so they can spend their working career free of the disease and retire like anyone else."

The National Mining Association has called the rule a "one-size-fits-all approach that fails to reflect the constructive suggestions from representatives of industry and labor."

The federal government says that miners, including young ones, continue to be diagnosed with black lung disease. Last month, the Labor Department's Office of Workers' Compensation Programs said it expects more than 7,400 claims to be filed this year because of the disease.

Sen. Jay Rockefeller, a West Virginia Democrat, said in a statement Thursday that while the rule represented a major step toward halting black lung disease, it's too early to claim victory.

"Limiting dust exposure is just one part of this fight," he said. "Just as important is providing health care and financial support for those who are already afflicted with black lung."

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Plane scare widens Ebola fear http://www.charlestondailymail.com/article/20140728/ARTICLE/140729276 ARTICLE http://www.charlestondailymail.com/article/20140728/ARTICLE/140729276 Mon, 28 Jul 2014 20:12:37 -0400

By KRISTA LARSON

and MARIA CHENG

The Associated Press

DAKAR, Senegal - No one knows for sure just how many people Patrick Sawyer came into contact with the day he boarded a plane in Liberia, had a layover in Togo and then arrived in Nigeria where authorities say he died days later from Ebola, one of the world's deadliest diseases.

Now health workers are scrambling to trace those who may have been exposed to Sawyer at three international airports in West Africa, from flight attendants to fellow passengers. Health experts say it's unlikely he could have infected others with the virus that can cause victims to bleed from their eyes, mouth and ears.

Still, unsettling questions remain: How could a man whose sister recently died from Ebola manage to board a plane leaving the country? Could Ebola become the latest disease to be spread by airplanes?

"The best thing would be if people did not travel when they were sick, but the problem is people won't say when they're sick. They will lie in order to travel, so it is doubtful travel recommendations would have a big impact," said Dr. David Heymann, professor of infectious diseases, London School of Hygiene and Tropical Medicine.

"The important thing is for countries to be prepared when they get patients infected with Ebola, that they are isolated, family members are told what to do and health workers take the right steps."

The World Health Organization is awaiting official confirmation from a laboratory in Dakar, Senegal, after Nigerian health authorities said Sawyer tested positive for Ebola, said Gregory Hartl, a Geneva-based spokesman.

The WHO has not recommended any travel restrictions since the unprecedented outbreak first emerged in the West African nation of Guinea back in March. At least 319 people now have died in Guinea, along with 224 victims in Sierra Leone along with 129 deaths in Liberia. Among the sick are two American health workers.

"We would have to consider any travel recommendations very carefully, but the best way to stop this outbreak is to put the necessary measures in place at the source of infection," he said. Closing borders "might help but it won't be exhaustive or foolproof."

The risk of travelers contracting Ebola is considered low because it requires direct contact with body fluids or secretions like urine, blood, sweat or saliva, experts say. Ebola can't be spread like flu, through casual contact or breathing in the same air.

Patients are only contagious once the disease has progressed to the point they show symptoms, according to the WHO. And the most vulnerable are health care workers and relatives who come in much closer contact with the sick.

Still, witnesses say Sawyer, a 40-year-old Finance Ministry employee en route to a conference in Nigeria, was vomiting and had diarrhea aboard at least one of his flights with some 50 other passengers aboard, sparking fear of possible fluid transmission. A person could contract it from traces of feces or vomit, health experts say.

Sawyer was immediately put into quarantine upon arrival in Lagos - a city of 21 million people - and Nigerian authorities say his fellow travelers were advised of what Ebola symptoms to watch out for and then were allowed to leave. The incubation period can be as long as 21 days, complicating the effort to trace who may be infected because they may not fall ill for several weeks.

Health officials rely on "contact tracing" - the process of locating anyone who may have been exposed, and then anyone who may have come into contact with that person. That may prove an impossible task given that other transiting passengers in Lome, Togo, where Sawyer had his stopover, have journeyed on to dozens of other cities.

"We are actively trying to find the whereabouts of all the passengers who took the same flights to and from Lome as that patient," said Napo Koura Gado, an official with the Togolese health ministry.

International travel has made disease spread via airplanes almost routine; past outbreaks of measles, polio and cholera have all been traced back to countries thousands of miles from where the germs first originated. Even Ebola has previously traveled the globe this way: During a previous outbreak in Ivory Coast in the 1990s, the virus infected a veterinarian who traveled to Switzerland, where the disease was snuffed out upon its arrival and she ultimately survived, experts say.

The mere prospect of Ebola in Africa's most populous nation has Nigerians on edge.

In Nigeria's capital, Abuja, Alex Akinwale, a 35-year-old entrepreneur, said he's particularly concerned about taking the bus, which is the only affordable way to travel.

"It's actually making me very nervous. If I had my own car I would be safer," he said. "The doctors are on strike and that means they are not prepared for it. For now I'm trying to be very careful."

It's an unprecedented public health scenario: Since 1976 when the virus was first discovered, Ebola outbreaks were limited to remote corners of Congo and Uganda, far from urban centers and staying within the borders of a single country. Cases first emerged in the West African nation of Guinea in March and before long others fell in Liberia and Sierra Leone.

Those countries are among the poorest in the world with few doctors and nurses to treat sick patients let alone to determine who is well enough to travel at an airport. In Sawyer's case, it appears nothing was done to question him or others until he fell sick on his second flight with Asky Airlines. An airline spokesman declined to comment on what precautions were being taken in the aftermath of Sawyer's journey.

Liberian Assistant Health Minister Tolbert Nyenswah told The Associated Press last week that there had been no screening at the Monrovia airport. That changed quickly over the weekend though when President Ellen Johnson Sirleaf announced that all borders were being closed except for major entry posts and the international airport.

A new travel policy by the Liberia Airport Authority covering inspection and testing of all outgoing and incoming passengers will be strictly observed, she said. And communities with large numbers of Ebola cases are to be quarantined too.

International flights also are departing from the capitals of Sierra Leone and Guinea, though airport officials there say they're already checking for signs of fever in departing passengers. Buckets of chlorine are also on hand at the airport in Freetown for disinfection purposes, said Sidie Yayah Tunis, director of communications for the Ministry of Health and Sanitation.

Still, detecting Ebola in departing passengers might be tricky since its initial symptoms are similar to many other diseases, including malaria and typhoid fever.

"It will be very difficult now to contain this outbreak because it's spread," Heymann said. "The chance to stop it quickly was months ago before it crossed borders ... but this can still be stopped if there is good hospital infection control, contact tracing and collaboration between countries."

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Programs help increase number of healthy babies http://www.charlestondailymail.com/article/20140728/DM01/140729284 DM01 http://www.charlestondailymail.com/article/20140728/DM01/140729284 Mon, 28 Jul 2014 19:56:03 -0400 By Whitney Burdette CHARLESTON, W.Va. - Increased access to educational and nutrition programs is helping lower-income women nationwide give birth to healthier babies.

A study conducted by Princeton University professor Janet Currie looked at birth weights, a common indicator of infant health, of babies born to black, unmarried, high school dropouts and white, married, college graduates. She found a shrinking disparity between the two groups.

In 1989, one in six babies born to lower-income women weighed less than the 5 1/2 pounds considered to be healthy, while one in 32 babies born to more economically advantaged women were above that threshold.

But experts say the shrinking gap has nothing to do with a single government policy. Instead, it reflects an increased access to prenatal care.

"I don't think government policy can take all the credit," Currie told the Washington Post. "But at the same time, there is evidence that our programs for pregnant women have a real impact on well-being."

The same is true in West Virginia. The state Department of Health and Human Resources offers several programs for economically disadvantaged women and children, including Birth to Three, Women, Infants and Children (WIC) and Right From the Start.

Toby Wagoner, DHHR spokesman, explained how Right From the Start works.

"Currently, Right From the Start provides comprehensive perinatal home visitation services to low-income women up to 60 days postpartum and care coordination for Medicaid eligible infants up to 1 year of age," he said. "Right From the Start also provides direct financial assistance for obstetrical care for West Virginia pregnant women who are uninsured or underinsured and are above income guidelines for Medicaid coverage."

Women can qualify for that financial aid if they have an income between 150 percent and 185 percent of the federal poverty level, are a pregnant teenager 19 or younger or are a non-citizen.

According to the Washington Post article, researchers found that Medicaid expansion under the Affordable Care Act means more women are visiting the doctor earlier in their pregnancies, although that has little effect on the baby's health. That could be because lower-income women face other environmental effects, such as pollution and violence, that can affect the fetus.

But in West Virginia, it seems Right From the Start is working. According to 2013 statistics, 91 percent of infants born to mothers participating in the program had a normal birth weight, 88 percent were born full term - greater than 37 weeks' gestation, 89 percent of women in the program attended their postpartum care appointment, 84 percent of infants had their five well-child visits, 92 percent of infants were up-to-date on their vaccinations and 76 percent of mothers in the program started a method of birth control after delivery.

"Prenatal women in (Right From the Start) are encouraged to use a method of birth control in order to prevent another pregnancy following birth," Wagoner said.

Nationwide, Medicaid finances about 42 percent of births, according to the American Congress of Obstetricians and Gynecologists. Additionally, black women are one-and-a-half times more likely to deliver a preterm infant and twice as likely to birth a very preterm infant (less than 28 weeks' gestation) than white women. That higher rate "cannot be accounted for by known risk factors."

Right From the Start works to reach women in all parts of the state. According to Wagoner, the state is divided into eight regions and each region has a Regional Lead Agency that provides Regional Care Coordinators to oversee community-based Designated Care Coordinators. Those coordinators not only assign patient referrals and promote the project, but also coordinate training for staff and recruit 29 obstetrical care providers and designated care coordination agencies.

In addition to Right From the Start care coordinators, 65 obstetricians, nurse practitioners, nurse midwives and family practice physicians in West Virginia and bordering states have letters of agreement with the program to provide care to pregnant women.

For more information on Right From the Start, call 304-558-5388.

Contact writer Whitney Burdette at 304-348-7939 or whitney.burdette@dailymailwv.com. Follow her at www.Twitter.com/wburdette_DM.

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Officials endorse HPV vaccine http://www.charlestondailymail.com/article/20140725/DM01/140729493 DM01 http://www.charlestondailymail.com/article/20140725/DM01/140729493 Fri, 25 Jul 2014 00:01:00 -0400 By Samuel Speciale CHARLESTON, W.Va. - Cervical cancer nearly destroyed Shelly Dusic's life, but now she's using her experience to encourage parents to get their children vaccinated against a virus often linked with causing the disease.

After spending six years in a wheelchair because of severe and constant pain - a time of misdiagnoses and being told her discomfort was in her head - Dusic finally found answers when a nurse looked at her medical history and called for a test that revealed she had a cantaloupe-sized tumor growing inside her abdomen.

Once diagnosed, Dusic had to choose whether to have a hysterectomy and live or cling to the hope she could fight it on her own.

Ultimately, Dusic had the surgery, but she said she never would have gone through what she did if she had access to the vaccination that helps prevent the disease that causes cervical cancer.

The human papillomavirus, or HPV, is one of the most common sexually transmitted infections in the country, but it can be contracted by non-sexual means.

Dusic, a health information specialist for the West Virginia Breast and Cervical Cancer Screening Program, said HPV is a contact disease that can be spread by a kiss or by simply not washing one's hands after touching an infected area.

"People don't think about that at all," she said.

HPV generally affects women more than men, and West Virginia is one of the worst states in terms of infection rates.

It's especially prevalent in communities of low socioeconomic status where access to quality health care is limited.

Estimated vaccination coverage in West Virginia, while higher than the national average, is still low according to health officials who say only 45 percent of girls have begun the three-dose HPV vaccination series and that only 36 percent finish. It's even lower in males.

The rise in infections and less-than-favorable vaccination rates has West Virginia health officials hoping a positive campaign will remove the stigmas surrounding the shot and ease the concerns parents may have.

Some opponents claim the vaccine can cause adverse health effects or even sterility. Others say endorsing the shot will encourage teens to start having sex.

Health officials say religious conviction is the most common reason parents do not let their children get vaccinated, and that some outright oppose any vaccination.

"If you can prevent it, why wouldn't you?" Dusic said.

That's why health officials are rallying around the vaccine, which greatly reduces the chance of women getting cervical cancer.

Getting parents to sign off on the optional vaccination is the next step.

A group of health care officials issued a call-to-action Thursday urging providers and physicians to recommend the vaccination because studies have shown that parents overwhelmingly consent and complete the series when it is strongly recommended by their primary care provider.

The West Virginia Bureau for Public Health recommends starting the vaccination in 11- or 12-year-old girls. The three-shot series takes six months to complete with a second shot being administered two months after the first and the final shot four months after that.

While the vaccine is not mandatory, it can be requested when students get their boosters and shots required to attend school.

Contact writer Samuel Speciale at sam.speciale@dailymailwv.com or 304-348-4886. Follow him at www.twitter.com/wvschools.

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Task force takes on county-wide heroin epidemic http://www.charlestondailymail.com/article/20140724/DM01/140729565 DM01 http://www.charlestondailymail.com/article/20140724/DM01/140729565 Thu, 24 Jul 2014 13:06:25 -0400 By Shawnee Moran Officials gathered Thursday morning at the Kanawha County Courthouse in an attempt to raise public awareness of the county-wide heroin epidemic.

The Heroin Eradication Associated Task force, also known as Kanawha H.E.A.T., was financed by $250,000 of the county's public safety grant money to address the growing dangers of the drug in the community.

"The county commission decided this would be in best interest of the public to try to dedicate some funding to do something about the heroin problem here in the area," said Terry Sayre, chairman of the task force.

In 2013, the Metro Drug Unit saw a 400 percent increase in heroin use, and officials said heroin overdoses now happen regularly.

"It's a daily occurrence. We've had people pass out at stoplights, at fast-food windows, and even with their kids in child seats in their car," said Charleston Fire Capt. Mark Strickland. "I saw my first overdose in 2001, and in the last three years there has been an off-the-chart spike in heroin overdoses."

The fire department is working in conjunction with the police department in an effort to try and eliminate heroin use in the city. Strickland said they can generally tell when the drug hits the street because they see an upswing in overdoses almost immediately.

"We find the heroin problem to have no social, racial or economic divide," he said. "It's a drug for all customers. Heroin is out there and it's cheap, readily available and people are using it. It's everywhere."

Members of the task force said the age group with the most heroin users is 30-39, followed by ages 40-49. According to their data, areas in Kanawha County with the most heroin-related problems are Charleston, South Charleston and Dunbar. They noted that heroin use is a problem for both the East End and the West Side.

Heroin users often misjudge the regularity and purity of the substance they inject, which often leads to critical or lethal overdoses.

Marianne Richardson, Charleston Area Medical Center's general emergency department director, said she sees varying reactions to drug overdoses.

"It's anywhere from decreased mental awareness to cardiac arrest. On average we see one (heroin overdose) patient a day," she said, though as many as eight overdose patients have come through the hospital system in a day.

The overdoses are treated with the drug Naloxone, commonly known as Narcan, which is used to counteract the effects of heroin.

Heroin is a depressant, which leads to a life-threatening depression of the user's central nervous system and respiratory system. When the counteracting drug is administered, it allows the user to breathe normally and counteracts feelings of euphoria and relaxation.

The main point of the task force's meeting, Sayre said, was to get the public involved to try and get the drug off the streets.

"We're trying to raise public awareness to where we can get the public to cooperate with law enforcement more to help with their investigations. If they suspect someone is a heroin dealer, we're going to send out the local police departments and the sheriff's department," he said. "If you have a friend that's addicted to heroin - if you're a true friend, you need to get them help and get them in treatment somewhere."

Follow the task force on Twitter @Heat_Task for more information.

Contact writer Shawnee Moran at 304-348-4872 or shawnee.moran @dailymailwv.com. Follow her on Twitter @shawneemoran22.

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Former Power executive to get prostate exam at game http://www.charlestondailymail.com/article/20140723/DM01/140729619 DM01 http://www.charlestondailymail.com/article/20140723/DM01/140729619 Wed, 23 Jul 2014 21:12:22 -0400 By Ashley B. Craig Andy Milovich is going to take one for the team in a humorous attempt to bring attention to a serious matter.

Milovich, general manager for the Myrtle Beach Pelicans minor league baseball team, will undergo a prostate exam today during the Pelicans' game against the Frederick Keys in Myrtle Beach, S.C. The exam, which will be conducted by a licensed physician, will be performed in the radio booth at BB&T Coastal Field during the seventh inning stretch.

Don't worry, only Milovich's head and shoulders will visible to the crowd.

Oh and one more thing - Milovich plans to sing "Take Me Out to the Ballgame," during the examination.

"I imagine it might be in more of a falsetto," Milovich said with a laugh when reached Tuesday.

Milovich, former general manager for the West Virginia Power, took a job in 2012 as the general manager for the Myrtle Beach Pelicans, farm team for the Texas Rangers. He was challenged last week by the front office staff to get a prostate exam during today's game. He said it started as a joke during a radio show.

The team runs various promotions during the season. Some are for fun but others have a serious message, like the "Strike Out Cancer" series that focuses on different types of cancer including esophageal cancer, breast cancer, testicular and prostate cancer and others.

Both Milovich's family and the Pelican organization had been touched by different forms of cancer in recent months, he said.

Tonight is Prostate Cancer Awareness Night at BB&T Coastal Field. The first 1,000 men over 18 years old to enter the park will receive a foam finger with a blue reminder ribbon.

"We wanted to raise awareness for prostate cancer, because it's the number two cause of death amongst men prematurely," Milovich said. "It's all preventable. With early detection it's almost always treatable."

A reporter asked Milovich last week during a radio show while discussing the promotional event if the team would also be giving away prostate exams. Milovich may have laughed the question off and said no, but he then was asked if he would get a prostate exam during the game.

"I said 'Alright I'll do it, but it's gotta be for a good cause. It's got to help Fallon," Milovich said.

Fallon Emery, a 10-year-old Carolina Forest girl, was diagnosed with brain cancer in December. Her battle with the disease has been chronicled on her "Fierce Fallon" Facebook page. Milovich's family are close to Fallon's family.

Milovich said he'd do it if Fallon's Facebook page reached 10,000 likes.

Fallon has been greatly supported by the community in her fight. The team is hosting a fund raiser for her on Aug. 2 at the ballpark.

Milovich received a number of questions from those in sports media about the challenge, including whether or not he was for real. He responded that he was.

The goal is to get more men to get themselves examined.

"This is something that should be done," Milovich said of having the exam. "I'm willing to kind of embarrass myself for the sake to taking that stigma away. If it will give a boy or girl a chance to play catch with their dad later in life then I'm happy to do it."

The story has been picked up by ESPN, Sports Illustrated, and numerous national sports radio outlets and publications.

By Tuesday, Fallon had more than 11,000 likes on her "Fierce Fallon" Facebook page. Fallon's mother explained to her what Milovich was doing to garner support for her, he said. Fallon thought his plan was funny.

"The response has really been overwhelming," Milovich said.

Dave Oster, a longtime friend of Milovich and the general manager of the Lake Elsinore Storm in California, pledged Monday night to match Milovich's challenge if the "Fierce Fallon" page reached 12,000 likes. By Wednesday evening the page had 11,288 likes.

While professional organizations vary on recommendations on who should and shouldn't get a prostate-specific antigen exam to look for signs of prostate cancer, some organizations recommend the test in men between the ages of 40 and 75 and in men with an increased risk of prostate cancer, according to the Mayo Clinic.

Milovich is 45 and tonight's exam will be his first, he said.

"It will be my first time, but luckily I'll have a diversion," he said. "And I'll be saving a co-pay."

Dr. Glenn Gangi with Atlantic Urology Specialists in Conway, S.C., will prepare for the exam in the media booth at the beginning of the 7th Inning. The exam will take place during the middle of the inning.

Milovich said only his face and maybe his shoulders will be visible to the crowd via video screen during the exam.

"Though the promotion is humorous in nature the exam is not and Andy is a trooper for sharing such a personal experience live," Kristen Call, Pelicans senior director of marketing, said in an email. "We are taking every precaution to keep the video and photos of the exam respectful to both Andy and our fans."

If Milovich was nervous at all about the exam he didn't show it during an interview Tuesday.

"Hopefully, I get good results," Milovich said.

Pelicans games are broadcast on ESPN 1490 in Myrtle Beach, S.C. The games also are available online at www.myrtlebeachpelicans.com or on MiLB.TV.

Contact writer Ashley B. Craig at ashley.craig@dailymailwv.com or 304-348-4850.

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Hospital board talks building projects http://www.charlestondailymail.com/article/20140723/DM01/140729646 DM01 http://www.charlestondailymail.com/article/20140723/DM01/140729646 Wed, 23 Jul 2014 18:36:32 -0400 By Charlotte Ferrell Smith Slides displaying plans and progress on building projects at Charleston Area Medical Center show how patient care will continue to improve, said Dale Wood, chief quality officer.

Wood, who made the presentation on Wednesday morning during the regular meeting of the CAMC Board of Trustees, discussed how the process will affect patients, visitors, parking and staff.

"It's like a bunch of dominoes to make things happen," he said.

While officials were already aware of the projects, Wood quickly went through a series of slides to update the board.

Construction at Memorial means losing parking spaces while large equipment is situated in the area through February of 2015. Additional staff will be on hand to guide people safely away from the construction zone. While parking near the work area will be lost for safety reasons, additional parking will be opened near the Heart and Vascular Center. Property purchased near Aladdin's Restaurant on Chesterfield Avenue will be available for staff parking with a shuttle service provided. Construction at Memorial will be done in stages with three new levels adding 109,830 square feet of space and 48 additional patient beds, including 16 for critical care and 32 for general medical care. There will also be space for adding another 48 beds when authorization and funding make that possible.

As CAMC continues to expand and offer additional services, temporary inconveniences will be compensated in terms of better patient care, he said.

The new CAMC Cancer Center is moving along as expected.

"We are on budget and on schedule," he said. "We plan to see patients in May."

David Ramsey, president and chief executive officer, said he was surprised with the building progress he saw on a recent tour of the Cancer Center.

University of Charleston President Ed Welch, who heads the quality committee, said advance directives and living wills become a challenge for hospital officials when family does not agree with a patient's wishes. However, the written decision of the patient must prevail in these instances, he said.

"We continue to work on that touchy, personal issue," he said.

He also suggested officials take a look at when a patient needs life prolonging therapy or palliative care. For example, it could be noted whether a patient was admitted through Hospice or traditional means in order to identify more quickly what kind of care may be needed.

He also mentioned a recent "miracle case" whereby a patient was admitted with numerous gunshot wounds, went home within a month, and continues therapy on an outpatient basis.

"It's phenomenal what CAMC can do to assist people," he said.

Larry Hudson, CAMC chief financial officer, said finances have improved for several reasons, including Medicaid revisions.

Gail Pitchford, CAMC foundation president, presented a strategic plan for continued fundraising. Last May, the foundation exceeded its $15 million fundraising goal for the new Cancer Center.

"With the Cancer Center under construction, donors who drive by can see that the money they give changes the delivery of health care in this community," she said. "One object of the campaign was not just to raise money but to raise awareness of the CAMC Foundation. We acquired 2,000 new donors as a result of the campaign. We've acquired new donors and we've got to keep them."

She called upon board members to make her aware of those who have influence in the community with talents for fundraising. The foundation is continuing to build its "grateful patients program."

Patients who thank health officials for excellent care often make donations, she said. When patients receive care there is a box to mark if they do not wish to receive information from the foundation. Otherwise, materials may be sent to them so they are aware of opportunities to donate. The foundation may have access to names and addresses for mailings while medical information remains confidential.

Pitchford also praised the generosity of employees who gave more than $500,000 toward the new Cancer Center.

Ramsey said Pitchford's leadership has been impressive.

"We are lucky to have Gail leading the foundation," he said. "She does a remarkable job."

Contact writer Charlotte Ferrell Smith at charlotte@dailymailwv.com or 304-348-1246.

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Some fruit sold at Kroger included in recall http://www.charlestondailymail.com/article/20140723/DM01/140729694 DM01 http://www.charlestondailymail.com/article/20140723/DM01/140729694 Wed, 23 Jul 2014 14:58:50 -0400 Some fruit sold at local Kroger stores is being included in a voluntary recall, after a California packing company learned it may have been contaminated with Listeria monocytogenes.

Wawona Packing Company of Cutler, Calif., is voluntarily recalling certain lots of whole peaches (white and yellow), nectarines (white and yellow), plums and pluots packed between June 1, 2014 through July 12, 2014.

Kroger issued automated calls to its Kroger Plus shopping card customers who purchased the products, which include peaches, plums, nectarines and pluots with peel-off stickers that include the wording "Sweet2Eat."

No other products are impacted by this recall, and no illnesses have been linked to this recall to date.

Kroger customers who purchased the affected fruit can return it to the store for a full refund.

Listeria, an organism which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems. Although healthy individuals may suffer only short-term symptoms such as high fever, severe headache, stiffness, nausea, abdominal pain and diarrhea, Listeria infection can cause miscarriages and stillbirths among pregnant women.

Consumers with additional questions may contact Wawona Packing at 1-888-232-9912, between the hours of 8 a.m. and 5 p.m. Monday through Friday, or visit www.wawonapacking.com for a copy of this press release.

"We are aware of no illnesses related to the consumption of these products" said Brent Smittcamp, president of Wawona Packing Co., in a news release. "By taking the precautionary step of recalling product, we will minimize even the slightest risk to public health, and that is our priority."

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