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Show Tuesday, March 9, 2004 mt&wm HEALTH NEWS FOR YOUR PHYSICAL AND MENTAL WELL-BEIN- Q New assault may finally wipe out tuberculosis threat prompts a wave ofvaccines, research Re-emergi- ng called Corixa Corp. is being tested on 20 healthy volunteers. A 7d in Winston-SaleN.C, Known through history as and St. Louis, tests on a second vaccine were begun in February consumption, the white plague and hectic fever, tuberculosis in 30 volunteers uninfected by TB. Alongside the proposed vac-ravages the lungs and wastes the body. It has felled statesmen cines, expected to be more effecand soldiers, poets and prisontive than the current version, a flood of research money has beers, drinkers and doctors in killing sprees that go back at gun to yield new treatments for least 3,000 years. TB that promise to be easier to administer and more effective. Today, this resilient and highly contagious bacterial infection That's important because many continues to rage, virtually patients fail to complete the current treatment a demanding unchecked, throughout the developing world. TB kills 2 milregimen of four drugs, taken lion people each daily for six to 18 d year, and months, when of the "A highly effective treatment is spotty world's population or incomplete, is estimated to be vaccine, in new forms of infected. It is the TB combination with a S3Vtnth-leadin- g tend to develop, as cause of death happened in severgood treatment al frightening U.S. worldwide, behind could actually heart disease, outbreaks during the 1990s. stroke, influenza eliminate the and diarrheal inAlso in the fections. disease." pipeline are other Even in the potential vaccines United States, Jerald Sadoff that could prevent where the disease tuberculosis infecpresident, Aeras Global TB Vaccine Foundation A nurse at a Los Angeles dink gives a TB, test to a man who recently has been brought tion or head off disease after infec-under tight con- .. tion does occur. trol, American And researchers are devising chance of becoming ill with the public health authorities are ing one of the two potential vacwatchful for a resurgence. Officines into the clinical trial phase more ways to detect TB infecdisease, HIV infection makes cials have sweeping powers to tion before it does any damage. and is laying plans for the vacconversion to active TB 20 cine's manufacture. "I think that times likelier, and an AIDS diFinally, the search for better quarantine TB's victims and force treatment, and the federal ways to control tuberculosis has could happen, and I hope it. agnosis multiplies the probabilicould happen in my lifetime." government has labeled tuberhelped forge new kinds of partty by 170. TB has become the culosis an "emerging infectious A new vaccine even if it's nerships among the U.S. govsingle largest cause of death of disease threat" on the same orernment, academic researchers, just a little better than the century-- AIDS patients worldwide. To create both vaccines now der as influenza, yellow fever vaccine still in use old pharmaceutical companies and could be the most efficient way and hantavirus, and a potential philanthropic organizations. entering the human-testin- g to stem a global epidemic, to The goal, say those familiar weapon of bioterrorists. phase, developers had to take But the first decade of the 21st with the broad fight against TB, head off new strains of account of the qualities that TB and to protect the is to relegate an age-oladverhave made TB so irrepressible. century could be the turning United Stateswhose porous The TB bacterium essentially point in the struggle against the sary to the history books. disease that killed Eleanor Rootricks the human immune sys"A highly effective vaccine, in borders aria" high immigrant tem by entering its cells and combination with a good treatsevelt, Frederic Chopin and all population make Americans five of the Bronte sisters. In vulnerable to health problems of making itself at home, often for ment, could actually eliminate the disease," says Jerald Sadoff, the Tacoma,, Wash., a vaccine develworld). Toyears. When TB comes to life and begins to multiply wildly, oped by the British pharmaceuti president of the Aeras Global day, just over half of new TB TB Vaccine Foundation, a non- cal company cases diagnosed in the United the immune system's normal dearid a Seattle-base- d fenses fail to recognize the bacprofit organization that is carry - States are among people born company outside the country and of terium as an intruder. Both of the test vaccines emthe Los Angeles area's more than 1,000 cases, the foreign-bor- n ploy genetic engineering and remake up over 80 percent. combinant DNA technology to flush the TB bacteria or parts Mexico is the most common of them out into the open so birthplace of those sick with Researchers are organizing two human trials to test whether new the immune system learns to TB, followed by the Philippines, tuberculosis vaccines are more effective than the current Bacille Vietnam, India and China. recognize an attack and fight Calmette-Gueri- n "The central tactic in the U.S. back. (BCG) vaccine. a The vaccine fight against TB has to be imParallel approaches: O starts from scratch, plucking proving the global situation," UCLAAeras team team says Dr. Peter Small, a Stanford two key protein-makin- g genes TB researcher serving as a profrom the TB bacterium, fusing A pair of TB genes is spliced into Tiny bits of the tuberculosis gene them onto a second harmless gram officer with the Bill & are spliced into the E. coli the BCG genome. The old Melinda Gates Foundation, bacterium, and mixing the revaccine then produces more TB genome. The resulting organism which is active in disease resulting organism into a broth of is placed into a mixture that proteins, causing a better miles of steel search. "Sixteen immunity boosters called "adju' which an immune includes activator, response. wire on the Mexican border will vants." triggers the production of many do nothing" to reduce the threat, The second vaccine, devel- - " TB proteins. TB proteins are TBpfoteins Small describes TB as a oped by UCLA infectious dishe adds. purified to remove ease specialist Marcus Horwitz global disaster outside the UnitE. coli proteins. ed States and, within American and moving into human trials borders, as a time bomb that has under the sponsorship of Jerald Activator mixture Sadoff s Aeras Foundation, uses yet to be disarmed. an existing vaccine known as In 2002, the U.S. death toll TB proteins from TB was 749, with 15,075 BCG as the basis for its candinew cases of the disease diagdate. The older vaccine's effec-e.coli nosed 3, 1C9 of them in Cali-fotiveness had waned after almost cells a century of use, so Horwitz 'a. Beyond U.S. borders, ''Macrophage The body responds to TB's path of destruction is far and his team set out to improve Human " each vaccine by producing it by snipping and splicing new more horrific. At the current antibodies antibodies. When rate of spread, TB is expected genes into the DNA of the live tuberculosis bacteria TB bacterium that makes up the to cause 35 million deaths Vaccine BCG vaccine. The added genes invade, the immune worldwide in the next 20 years. set in motion a complex chain of In addition to its recent system recalls the vaccine knack for evolving new strains events that results in the mobiresponse, produces antibodies and alerts lization of the immune system that are tough to treat with exmacrophages, or cells that isting antibiotics, the TB bacteri- against TB. attack foreign matter. um is opportunistic. Moreover, J Both trials are designed to test it has found new prey with the human subjects' ability to tolerate the vaccines without ill efpandemic of HIV and AIDS. AlSourcar UCLA mnt Wtefiow Diattat Research rwttu fect. They follow tests on aniGraphics ivportne by Ctry Browniteln-Stnllagthough a healthy individual infected with TB has a mals, in which both vaccines ltll ClflBOnloUoHTlm Melissa Healy LOS ANGELES TIMES' -- one-thir- 'A drug-resista- nt ANNE CUSACKLos Angeles Times arrived to the United States from the Philippines. ' drug-resista- d Giaxo-SmithKli- Aiming for a better shot GSK-Corix- g conferred immunity against TB at high rates. The tests now under way are the first step in a lengthy and expensive process of proving a new vaccine safe and effective in preventing disease in humans. It is extraordinary enough that two different vaccines for the same disease are coming to the human-testinstage in the same month. Even more extraordinary is that several more are expected to follow in the coming years. Most extraordinary of all, however, is that they should be for tuberculosis, a disease that primarily afflicts the developing world. Even in the United States, tuberculosis disproportionately affects minorities, the poor and the imprisoned. Four in five new cases of TB in the United States are among racial or ethnic minorities. In recent years, outbreaks in Washington, Oregon, Maine, North and South Carolina and Mississippi have tended to start in populations of homeless people, prisoners, intravenous drug users and heavy drinkers, although they quickly moved beyond those groups. (Though the stigma of TB infection makes many sufferers reluctant to discuss it, its vic long-lastin- g tims are not all faceless: Among the living who have fought back TB are former South African President Nelson Mandela, Ringo Starr and pop diva Tina Turner.) The demographics of TB threatened to make the disease an orphan when it came to pharmaceutical companies' investment and charity groups' fund raising. Says UCLA's Horwitz, who developed one of the two new TB vaccines starting human trials, "There's no private money for TB research. It just doesn't happen. You don't have nights at the opera or 10K walks for TB research." For pharmaceutical companies, the market might be vast but too poor to promise a payback worth years of risky research and development. But in the late 1980s and early 1990s, a resurgence of TB outbreaks in the United States and an alarming rise in cases resistant to standard drug treatments prompted the federal government to step up basic scientific research on TB. U.S. government spending on the hunt for new treatments and vaccines now tops $80 million inper year, a more than d crease since the early 1990s. le 25-fol- O O xyj rr , , j&&- o Los Angeles Putffic Libraiy At a Pasadena, Calif, sanatorium in 1928, one of many in Southern California, young male TB patients are exposed to fresh air and sunlight. Look for personalized assistance with health insurance Dear Savvy Senior, I am about to turn 65 and Through grants directed to states, SHIPS provide free counseling and assistance by telephone or interactive sessions, public education presentations and programs, and media activities. There are currently SHIPS in all 50 states plus Washington, D.C, Puerto Rico and the Virgin Is- - could sure use some help. I have lots of questions about the new Medicare drug benefit and all the changes coming in a few years. I also want to find out what all Medicare covers and what my best options are. Do you know where can I get f. some health insurance advice without being told to read SHIP Medicare manual? Medicare Nutty Jim Miller health-insuran- ; an-6th- er ' Dear Nutty, I have a great solution. It's called SHIP, also known as the j State Health Insurance Counsel:. ing and Assistance Programs. Available nationwide, SHIP ofe fers free counseling 1 and assistance to people with . ; Medicare and their families. ' Here's how it works. one-on-on- . :, Savvy Senior face-to-fa- tailed state and federal Medicare information that can: I Inform you on the new Medicare reform changes and benefit and Erescription drugand understand V your options. I Help you understand the services original Medicare benefits by Specially trained SHIP counexplaining which services are selors offer information, coun covered under Parts A and B and your Medicare summary seling and assistance to Medicare beneficiaries and their notice. v, families on a wide range of .. Hep you make informed f choices about Medicare cover- Medicare, Medicaid and Medi-ga- p matters, including ; age opticas, including the MedicareChoice health plan MedicareChoice options, soon care insurto be called Medicare Advan- options, long-terance and preventive care. Coun- tage. selors have direct access to de-I Provide assistance and in ' . . - ' . ' formation on Medicare claims and billing problems, as well as Medicare appeals, and assist with appeals paperwork. I Help you select a Medigap insurance policy by explaining the benefits offered under each plan, what they cost, and provide you with a list of companies that sell Medigap plans. I Inform you about eligibility for prescription drug programs and programs that pay , , Medicare deductibles, and Part B premiums. I Provide information on the many public benefit programs for those with limited income and assets. I Help you understand your Medicare rights and how to sub-m- it a complaint about medical care or treatment. I Inform you about Medicare fraud and abuse. SHIP counselors SHIPs for the most part are made up of volunteers supported by local sponsoring organizations. Paid staff manage these local programs and also serve as SHIP counselors. Under the direction and support of state program directors and trainers, SHIP counselors receive extensive training and continuous ongoing information updates about Medicare and other health insurance topics. Currently, SHIP has around 1,100 sponsoring organizations nationwide supporting over 12,000 counselors and staff. Last year alone, the SHIPS served more than 3 million Medicare beneficiaries, with about 2.5 million of those served or telethrough phone counseling sessions and . one-on-o- approximately 500,000 served through SHIP presentations and public education programs. Savvy note: Contact SHIP if you are interested in becoming a volunteer. How to find your SHIP For more information or to locate your state or local SHIP, visit the Medicare Web site at www.medicare.gOvContactsR elatedShips.asp or call Medicare at Some states will have a differ- ent name for their SHIP program, but they usually cover the same basic services. Always ask for your State Health Insurance Counseling Program. Send yqur senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070. Si'.V H: |