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From KQED

San Jose Police Crack Down On Violence

The San Jose Police Department is cracking down on violent crime after the city's 25th homicide this year.

KQED Launches Affordable Care Act Guide

Are you confused about Obamacare? KQED and The California Report created a guide to help answer your questions about the Affordable Care Act.

California Nurses Seek Greater Workplace Protections

Just last weekend, a patient at a Los Angeles hospital stabbed a nurse with a pencil. The same day, another nurse at another L.A. hospital was attacked with a knife. Nurses across the state are calling for greater protections from violent patients. Lawmakers will vote on a bill Thursday that would require hospitals to do more to prevent violence at their facilities.

Calif. Could Become Toughest State on Use of Livestock Antibiotics

In Sacramento, advocacy groups like the Natural Resources Defense Council are pushing an Assembly bill that would make California the toughest state in the nation on the use of antibiotics in livestock. The fear is that feeding drugs to livestock like beef and dairy cattle promotes pathogens that resist antibiotics. But even the bill's backers say it has some powerful opponents.

PBS NewsHour

Money, the root of all infections

Money and saving

Your money’s no good here. Creative commons image by y 401(K) 2013

Don’t accept anyone’s dirty money. Not because it’s wrong, but because it’s loaded with germs.

New York University researchers tested DNA on 80 dollar bills and found that the surface of paper currency hosts hundreds of bacteria types. In total, 3,000 types of bacteria were identified. The most commonly found strain causes acne. Others are associated with gastric ulcers, pneumonia and food poisoning.

“We actually found that microbes grow on money,” NYU’s Center for Genomics and Systems Biology’s director of genome sequencing Jane Carlton said to the Wall Street Journal.

The tested bills were collected from a Manhattan bank and the DNA collected was incredibly diverse. Half the DNA could be traced to humans. There were also occurrences of horse and dog DNA and even of white rhino. Even miniscule traces of anthrax and diphtheria were found.

But banks are afraid of counterfeiters, not germs.

While U.S. notes higher than two dollars are embedded with a security thread detectable by light, there are no features that guard against harmful bacteria.

Aside from sealing your cash in an airtight container and never touching it, a 2010 study published in Foodborne Pathogens and Disease suggests a change in material could help.

Researchers reported lower levels of bacteria on bills made of polymer, which is not absorbent, than ones based in cotton. Countries like Canada and Bhutan have already switched over. U.S. bills are still printed on a cotton-linen blend lasting just over 21 months.

The post Money, the root of all infections appeared first on PBS NewsHour.

Appeal growing among kids, FDA cracks down on ‘wild west’ of e-cigarettes

Photo by Christopher Furlong / Getty Images

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JUDY WOODRUFF: The U.S. Food and Drug Administration announced today that it intends for the first time to regulate the ever-growing business of electronic cigarettes. Sales have grown to $3 billion a year. And some public health experts are worried about its rise.

The number of middle and high school students using e-cigarettes doubled between 2011 and 2012. Under the new rules, sales would be banned to anyone under the age of 18. Companies would have to register their products and ingredients with the FDA, but they can continue marketing to adults.

New regulations would also apply to cigars, pipe tobacco and hookahs, or water pipes, for the first time.

There are many questions about the agency’s approach.

Mitch Zeller is the director of the FDA’s Center for Tobacco Products. And he joins me now.

Welcome to the NewsHour.

MITCH ZELLER, Director, Center for Tobacco Products, Food and Drug Administration: Thank you, Judy.

JUDY WOODRUFF: So, right now, there aren’t regulations governing electronic cigarettes. Why was it necessary to put some on now?

MITCH ZELLER: Congress put FDA in the business of regulating cigarettes, smokeless tobacco in 2009, and has a definition of a tobacco product in this law that didn’t include e-cigarettes, cigars, pipe tobacco, but gave FDA the authority, through rule-making, to expand its jurisdiction to meet other products that meet that definition of a tobacco product.

What we did today was a historic announcement that says we’re proposing to expand our authority to cover e-cigarettes and these other categories?

JUDY WOODRUFF: So we know research is still under way. You at the FDA talked about that today. But what is known right now about the health concerns around these electronic cigarettes?

MITCH ZELLER: It’s the Wild, Wild West. It’s buyer beware.

We have e-cigarettes that are exploding in car chargers, e-cigarettes that are exploding in wall sockets at home when people try to recharge them. We have e-cigarette users who are saying, this is the greatest thing that I ever had. It has helped me get off cigarettes.

And, as you said, we have a doubling of the number of middle and high school kids who used the e-cigarettes between 2011 and 2012. It’s going in all different directions. And there’s absolutely no regulation of manufacture, sale of distribution of these products.

JUDY WOODRUFF: So what effect do you think rules — and, granted, there’s a reaction period, a comment period.

But once these are effect, assuming they go into effect, what will change, do you think?

MITCH ZELLER: FDA is a science-based independent public health agency.

And when this rule goes final, we will be the gatekeeper standing between the companies, their product developers, their marketers and consumers. And we will be the ones to make the decisions on whether health claims can be made. We will be the ones to make decisions reviewing evidence on whether new products can come to market.

Right now, none that is in place because these products aren’t being regulated.

JUDY WOODRUFF: So, let me just — there is a lot of comment already about what was said at FDA.

Let me just read you a couple of comments. This is someone who is normally a friend of the administration, Senator Dick Durbin, Democrat of Illinois. He had been pushing the FDA to do something about e-cigarettes. He called your announcement today — and I’m quoting him — “a political compromise with the tobacco industry.”

Is he right?

MITCH ZELLER: Well, the senator is obviously entitled to his position.

What we have done today with this proposed rule is foundational. We can’t get to issues like advertising on television or what to do about the flavors in e-cigarettes until we have jurisdiction over them. And we can’t have jurisdiction over them until we complete this rule-making. This is a very important first step.

JUDY WOODRUFF: So are you saying this was as far as you could have gone right now?

MITCH ZELLER: This is as far as the regulatory science can take us.

Think of it as a foundational step that will enable to us address all the other aspects of e-cigarette sales, cigar sales, etcetera.

JUDY WOODRUFF: And I ask that because another –  another part of Senator Durbin’s comment, he talked about the fact that you — there’s still going to be marketing of these candy-flavored electronic cigarettes that children, young people will be exposed to.

And he basically said — in fact, again, quoting — “Parents across America — across America lost their best ally in protecting their kids from this product.”

MITCH ZELLER: Well, I really respect the senator’s point of view.

But there needs to be an understanding that in order to ban flavors in e-cigarettes, that requires an entire separate rule-making, which we can’t do until we have regulatory authority over these products. We are concerned about the marketing and the appeal of e-cigarettes to kids. We need the regulatory authority over the products in the first place to address those kinds of issues.

JUDY WOODRUFF: We — you also today — in addition to e-cigarettes, you issued regulations surrounding cigars, as we mentioned, pipe tobacco, hookahs, the name for the water pipes. Why move into that area, an area that FDA had not been in before?

MITCH ZELLER: There is good news from a public health concern.

The consumption of cigarettes is down. The bad news is, the consumption of all these other products is up. And none of these other products are being regulated by FDA. Our job is to regulate all the products that meet the definition of a tobacco product, and that’s we have proposed to do that today.

JUDY WOODRUFF: But you didn’t — I was reading that you excluded, for example, certain kinds of hand-wrapped, hand-rolled cigars. How did you decide what you wanted to impose regulations on and what you wouldn’t?

MITCH ZELLER: Well, with cigars, we have actually proposed a series of options.

Under one option, all cigars would be included. And in response to things that we heard about something that might be unique about premium cigars, different pattern of use that might have different impacts on public health, we put another option out there that would exempt premium cigars. But these are all regulatory options for the public to comment on.

JUDY WOODRUFF: I just finally want to ask you — again, in reading what manufacturers had to say, a number of them said they are concerned, they’re worried, concerned about what this could mean. But several of them said they don’t have a problem with this.

One I saw called this very encouraging. Does it is a something that some manufacturers think it’s a good idea what you did today, that maybe it’s not tough enough?

MITCH ZELLER: I leave that for others to judge. And it’s a proposed rule, and any interested party can comment on it.

The bottom line is tobacco use remains the leading preventable cause of death and disease in this country. And when these rule goes into effect, we will be doing more to protect the public from the harms of tobacco use than ever before.

JUDY WOODRUFF: Mitch Zeller, you are the director of the Center for Tobacco Products at FDA.

We thank you very much for being with us.

MITCH ZELLER: Thank you.

The post Appeal growing among kids, FDA cracks down on ‘wild west’ of e-cigarettes appeared first on PBS NewsHour.

FDA proposes new regulations for e-cigarettes

Photo by Christopher Furlong / Getty Images

Photo by Christopher Furlong / Getty Images


Citing efforts “to make the next generation tobacco-free,” the U.S. Food and Drug Administration proposed new rules Thursday for e-cigarettes that would regulate the devices in a manner similar to traditional cigarettes.

The new rule would require manufacturers of e-cigarettes –- battery-powered gadgets that produce an inhalable nicotine-vapor, rather than the smoke of burning tobacco –- to register with the FDA, disclose their ingredients, and label their products with nicotine warnings. The rule would also ban retailers from selling these products to minors and prohibit companies from giving out free samples.

The rules would also apply to previously unregulated smoking products, including cigars, nicotine gels, and pipe and waterpipe (hookah) tobacco, components of what Mitchell Zeller, director of FDA’s Center for Tobacco Products, calls “today’s rapidly evolving tobacco marketplace.”

Nothing seems to represent this new tobacco landscape better than e-cigarettes, an increasingly popular smoking alternative, which have been the subject of heated debates over their appeal to minors and their impact on the overall industry. Sales are expected to reach $2 billion this year, about 2 percent of the overall U.S. tobacco market.

The new regulations diverge from those over traditional cigarettes in a few key ways: They do not limit sweeteners or fruit flavoring, which some critics believe may lure children, and they do not restrict online sales.

“The FDA’s proposal does nothing to [rein] in the Wild West marketing of e-cigarettes to kids,” said Stanton Glantz, head of the Center for Tobacco Control Research and Education at the University of California, San Francisco.

But others welcomed the FDA’s announcement, including Matthew Myers, president of the Campaign for Tobacco-Free Kids, who called the news “long overdue.”

Commencing April 25, the proposed rule will be open to a 75-day public comment period, after which time FDA will issue a final ruling.

The post FDA proposes new regulations for e-cigarettes appeared first on PBS NewsHour.

New Hepatitis-C drug raises hope at a hefty price

Inside of a Gilead Sciences Lab

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JUDY WOODRUFF: Now: Who should pay when drugs are very effective, but extremely expensive?

That’s an important question for the U.S. health care system as new treatments come along, and it’s a matter of real concern over a new drug that has a 90 percent to 100 percent chance of curing the hepatitis C virus. Its manufacturer announced record sales yesterday of more than $2 billion in just the first quarter of the year.

Profits, coverage and costs are all at issue, as Hari Sreenivasan reports.

HARI SREENIVASAN: Kim Bossley knows how fragile life can be. In 2005, Bossley was diagnosed with hepatitis C, a blood-borne virus that can destroy the body’s liver.

KIM BOSSLEY: I went from stage one to stage four, decomposed liver, very quickly.

HARI SREENIVASAN: News of her rapidly declining health was devastating for the 46-year-old mother of two.

KIM BOSSLEY: You fall into a depression when you’re diagnosed with hep C. Your own mortality rate hits you.

DR. GREGORY T. EVERSON, University of Colorado Hospital: That’s a pretty good response.

HARI SREENIVASAN: This fall, after nine years of battling the virus, Kim Bossley was accepted into a treatment trial with a new drug called Sovaldi.

DR. GREGORY T. EVERSON: So, Kim, we will check your labs here.

HARI SREENIVASAN: Almost immediately after taking Sovaldi, the hepatitis C virus disappeared.

DR. GREGORY T. EVERSON: Not detected, not detected, not detected.

HARI SREENIVASAN: Bossley’s doctor, Gregory Everson, is an expert on the hepatitis C virus. He says results with Sovaldi are remarkable.

DR. GREGORY T. EVERSON: Do you feel like you can do what you want to do on this treatment?

KIM BOSSLEY: Yes.

DR. GREGORY T. EVERSON: Yes.

HARI SREENIVASAN: A hepatologist at the University of Colorado hospital, Everson has treated some 200 patients with the new drug.

DR. GREGORY T. EVERSON: Kim’s response is typical. Her viral load was in the millions — within a week or two, undetectable. That is what we’re seeing in almost all the patients we’re treating today. It’s really quite extraordinary.

HARI SREENIVASAN: In fact, across the United States, hepatitis C patients are experiencing the same dramatic results, so much so that Dr. Everson calls the new drug manufactured by Gilead Sciences a game-changer.

DR. GREGORY T. EVERSON: We’re not talking about chronic disease anymore. We’re talking about getting rid of the infection completely. We’re talking about a complete cure rate.

HARI SREENIVASAN: And that is welcome news for the three million Americans infected with the hepatitis virus, 25 percent of whom are projected to die from it.

Even better news, in December, the Food and Drug Administration approved Sovaldi. But as spectacular as Sovaldi appears to be, so too is its price tag. Each pill is $1,000. And at a typical treatment of 120 days, the drug’s extraordinary cost has raised concerns.

MATT SALO, National Association of Medical Directors: The new development is simultaneously very exciting in terms of its efficacy, but potentially very, very frightening in terms of its cost, because we’re talking about a nexus of a drug that is, on the face of it, very expensive.

HARI SREENIVASAN: Matt Salo heads the National Association of Medicaid Directors. He says states are scrambling to figure out how to pay for Sovaldi with government-funded insurance, particularly when existing drugs are 50 to 70 percent effective.

MATT SALO: Medicaid is actually kind of used to dealing with pharmaceutical treatments that are very expensive, but for small numbers of people. With hepatitis C, we know there are at least three million people and potentially as many as five million people in this country who have hepatitis C.

So when you multiply those two, you are really looking at a game-changer in terms of cost.

WOMAN: One a day of that one.

HARI SREENIVASAN: Kim Bossley’s treatments are free because she’s part of the study for those with advanced liver disease. And while she agrees the drug’s price tag is high, she says the combination of drugs she used before Sovaldi, interferon and ribavirin, were extremely rough.

KIM BOSSLEY: There is no comparison.

HARI SREENIVASAN: Her previous drug treatment, she says, caused exhaustion, depression and hair loss.

KIM BOSSLEY: It is a very harsh regimen. It’s very debilitating.

HARI SREENIVASAN: In fact, Dr. Everson said the existing drug treatments are so tough on his patients, many hepatitis C sufferers avoid them altogether.

DR. GREGORY T. EVERSON: Most patients didn’t even want the treatments because of the side effects. People wouldn’t even come for treatment. They wouldn’t get their hepatitis C addressed.

HARI SREENIVASAN: And beyond the physical costs, Everson says there is a price for in the curing the virus.

DR. GREGORY T. EVERSON: It’s one of the costliest diseases when you get to the end stages, where people start to have complications of cirrhosis.

HARI SREENIVASAN: That point is echoed by John McHutchison, executive vice president at Gilead Sciences.

JOHN MCHUTCHISON, Gilead Sciences, Inc.: The costs of caring for patients with hepatitis C are not all up front. So whilst it might be expensive to treat somebody up front now, by curing somebody, you are preventing the costs of care of that patient later on, so, as their disease progresses over time, the cost of liver transplant, the cost of caring for somebody with liver cancer.

So if you can treat more people, and spend those dollars up front to cure those people, in the long-term, and over the long-term horizon, you will save the costs to the health care system.

NARRATOR: If you are one of the millions of people with hepatitis C, you haven’t been forgotten.

HARI SREENIVASAN: But while Gilead calls Sovaldi a cure, it is not a vaccine. Hepatitis C, which is transmitted through blood, can be contracted more than once. The most common way to get the virus is through I.V. drug use.

MATT SALO: One of the things to keep in mind with Sovaldi is that this is not an immunization. This doesn’t make someone hepatitis-free forever. And if you got hepatitis C because of certain risky behaviors and you go and you get, in effect, cured, there is nothing to prevent from you getting it again if you relapse back into those same behaviors.

HARI SREENIVASAN: Kim Bossley contracted the virus from a blood transfusion at her birth. Bossley was the first baby born to a mother who had undergone a kidney transplant. She was featured in “Good Housekeeping” magazine as a miracle baby. During the birth, Kim’s mother received a transfusion of blood infected with hepatitis C.

But neither knew they had the virus until getting sick later in life. Bossley’s mother ended up dying from the condition, something that makes Kim’s own condition even tougher.

KIM BOSSLEY: Seeing my mom suffer through the latter part of her stages, it really took a lot out of me, to the point where I finally had to — you know, this is not how mom or I want to live. You know, I want to fight. I want to find a cure.

HARI SREENIVASAN: As new sophisticated drugs to treat all kinds of conditions enter the market, Matt Salo says the question of costs will likely arise again.

MATT SALO: It’s not a Sovaldi question, per se, because this really is the tip of the iceberg. There are so many other drugs that have the potential of bringing on one hand, you know, incredible improvements in human life and health and well-being, but on the other hand extraordinary costs.

HARI SREENIVASAN: Salo would like to see a national dialogue about what insurers should cover.

MATT SALO: I think it is critically important that we start having that conversation about, how do we value health, what price health, and what price pharmaceuticals? I think this is an important conversation we need to have.

HARI SREENIVASAN: For her part, Kim Bossley has started a foundation to hep offset drug costs for other hepatitis patients.

GWEN IFILL: Online, you can read about how free samples can influence what doctors prescribe to their patients. That’s on our health page.

The post New Hepatitis-C drug raises hope at a hefty price appeared first on PBS NewsHour.