The Morning Drill: October 20, 2011

A collection of dentistry and health related links/comments for your day.

Unvaccinated Kids Behind Largest U.S. Measles Outbreak in Years: Study

The largest U.S. outbreak of measles to occur in 15 years -- affecting 214 children so far -- is likely driven by travelers returning from abroad and by too many unvaccinated U.S. children, according to new research.

The finding could highlight the dangers of a trend among some U.S. parents to skip the measles-mumps-rubella (MMR) vaccine for their children, out of what many experts call misguided fears over its safety.

Dr. Andrew Pavlo, professor of pediatrics at the University of Utah and spokesman for the Infectious Diseases Society of America (IDSA), said, "The good news is that we are seeing introductions of measles that are being contained as small outbreaks."

Pavlo credits containment to high levels of vaccination and the rapid response by public health officials. However, if an outbreak occurred in a "really susceptible population the outcome could be very different," he said.

"What would happen in an area with a lot of vaccine refusers? Then you might see a much larger outbreak," he said.

Several measles-related studies were unveiled at the annual IDSA annual meeting, currently being held in Boston.

In the first report, U.S. Centers for Disease Control and Prevention (CDC) researchers chronicled the nation's ongoing outbreaks in 2011.

Most of those sickened were not vaccinated against the disease, CDC researchers said.

Before the vaccine became available in the 1960s, some three to four million people contracted measles every year. Of those, 48,000 were hospitalized, 1,000 were permanently disabled and about 500 died, the CDC said.

Unfortunately, "we have experienced an increased incidence of measles this year," said Huong McLean, lead researcher and CDC epidemiologist. "Typically we see 60 to 70 cases a year, this year we have 214 as of Oct. 14."

Among those people infected, 86 percent were unvaccinated or their vaccination status was unknown. Thirteen percent were under one year old -- too young for vaccination.

Throughout the United States, 68 of the patients have been hospitalized, 12 with pneumonia.

Free LA medical clinic to draw 5,000 uninsured

More than 5,000 people are expected to show up for free medical care at a Los Angeles arena starting Thursday.

The four-day clinic, organized by nonprofit CareNowLA, aims to provide health services for the impoverished and uninsured ranging from filling cavities to eye exams to cardiology checkups.

CareNowLA has lined up some 800 medical professionals to volunteer their services at the Los Angeles Memorial Sports Arena, but the nonprofit says still more dentists, nurse practitioners and primary care physicians are needed.

People lined up more than 24 hours in advance earlier this week to obtain wristbands that will allow them to enter the clinic. After treatment, patients will be referred to local medical centers that have offered to provide free follow-up care to the patients.

How Do I Run Barefoot With Shoes on?

There is a plausible theory that mankind came down from the trees to run across the African savannah in pursuit of prey. Running is not much in demand as a survival skill anymore, but it is by far and away the most popular participation sport in industrialized nations. This may be great for cardiovascular health, but it is apparently a disaster orthopedically; a typical estimate is that 60% of runners suffer injuries a year. Such high injury rates seem somewhat of an anomaly if we were indeed "born to run." I doubt that, for example, 2 out of every 3 eagles suffer wing injuries each year.

Some runners have used the evolutionary origins of running as a premise to argue that we should run barefoot (those proto-humans in Africa many millions of years ago were certainly not wearing Nike Lunarglides). Recent years have seen some runners abandon high-tech running shoes in favor of bare feet or "minimalist" shoes that mimic a barefoot running style. This has led to debates about whether the best way to avoid injury is to run with or without shoes.

Certain aspects of this debate are fairly settled. Few dispute that barefoot running is a very recent phenomenon in the United States or that, whatever the relative overall rates of injury, barefoot runners are more likely to experience ankle and foot injuries whereas those in running shoes suffer injuries of the knee, thigh, and hip. This makes the barefoot running debate pretty much guaranteed to generate more rhetorical light than scientific heat:

More Than One in Ten Americans Take an Antidepressant

Prozac Nation, indeed — 11% of Americans aged 12 and up now take an antidepressant medication, though less than one third of them have seen a mental-health professional in the past year.

So say stats from the Centers for Disease Control and Prevention that paint a portrait of who used the medications in 2005-08. The report covers nearly 13,000 participants in the ongoing National Health and Nutrition Examination Survey (NHANES).

The rate of antidepressant use has been climbing, rising by almost 400% since 1988-94, the CDC says. Women are significantly more likely to take antidepressants in every age group except the youngest tracked in this report — ages 12 to 17. The high-water mark for antidepressant use is 23%, seen in women aged 40 to 59.

Nearly 14% of whites take antidepressants, far more than the 4% of blacks and 3% of Mexican-Americans who report taking the medications. But income level is not a determinant of use, the report finds.

Despite the widespread use of antidepressants, the majority of people with severe depressive symptoms — about 66% — are not taking the drugs. Only 20% of men with the most severe symptoms are taking a drug.  About 8% of people reporting no depressive symptoms are taking the drugs, which could be because they’re being successfully treated by the drugs, or because they’re taking the drugs for other conditions.

And the data indicate that a significant number of people who are taking antidepressants — even more than one — haven’t seen a mental-health professional in the past year. Just 29% of those taking one drug and 48% taking two or more report seeing a psychologist, psychiatrist, psychiatric nurse or clinical social worker in that time period.

Enjoy your morning!