Does gum disease indicate future joint problems? Study links gum-disease bacterium to collagen-caused rheumatoid arthritis

Although researchers and clinicians have long known about an association between two prevalent chronic inflammatory diseases - periodontal disease and rheumatoid arthritis - the microbiological links have been unclear; a new study suggests this link is causative and that the bacteria responsible for gum disease leads to a faster progression of rheumatoid arthritis.

In a recent article published in PLoS Pathogens by University of Louisville School of Dentistry researchers say, "The bacterium responsible for periodontal disease, Porphyromonas gingivalis, worsens rheumatoid athritis by leading to earlier onset, faster progression and greater severity of the disease, including increased bone and cartilage destruction," according to a U of L news release.

The study says the bacterium produces an enzyme that worsens collagen-induced arthritis, a form of arthritis similar to rheumatoid arthritis produced in the laboratory.

The study was led by Oral Health and Systemic Diseases Group researcher Dr. Jan Potempa and a team that also studied another oral bacterium for the same effect, and found it did not affect collagen-induced arthritis or suggest a link to rheumatoid arthritis.

“This ground-breaking conclusion will need to be verified with further research,” said Potempa. Although the specific cause for the disease remains unknown, Potempa said he hopes these findings will shed new light on the treatment and prevention of rheumatoid arthritis.

An estimated 294,000 children under age 18 have some form of arthritis or rheumatic condition, says 2010 data from the Center for Disease Control and Prevention; this represents approximately 1 in every 250 children in the U.S. An estimated 1.5 million adults had rheumatoid arthritis in 2007. Click here for more information from the CDC.

Hard-hitting TV ads against smoking do motivate smokers, like one mother from Elizabethtown, to quit

Hancock with CDC Director Tom Frieden

A 38-year-old Elizabethtown mother's response to a federally funded anti-smoking advertising campaign has been featured in national news this week, showing that these graphic ads can motivate smokers to quit.

Lisha Hancock's decision to stop her two-decade smoking habit was sparked by her viewing of a Centers for Disease Control and Prevention’s “Tips from Former Smokers” campaign commercial, reports Sarah Bennett of The News-Enterprise in Elizabethtown.

Hancock's husband often urged her to quit, and several of her relatives died from smoking, but she still didn't quit. She continuously had a sore throat and clogged sinuses, but she still didn't quit. Then, she saw the commercial.

The advertisement featured raw images of Terrie Hall, a North Carolina woman who was diagnosed with throat and oral cancers at age 40, getting ready in the morning by putting on a wig, artificial teeth an an artificial voice box inside a small hole in her neck, since throat cancer forced her to have her larynx removed.

TV spokeswoman Terrie Hall with grandson's picture

"The only voice my grandson’s ever heard is this one,” Hall says in a robot-like voice, displaying his picture. UPDATE: Hall died Sept. 16.

The ad made a lasting impression on Hancock, who told Bennett she decided to quit smoking after watching the ad with her son: “One time my son asked me, ‘Mom, why does her voice sound like that?’ I said, ‘Because she smoked.’ Then he asked, ‘So you’ll sound like that?’”

Hancock said she had tried to quit before, but "There's nothing that touched me like Terrie's ad. It definitely impacted my life and, in return, impacted my family's life. We all live happier and healthier now."

Hancock started to quit eight months ago. Using nicotine lozenges and a combination of exercise and healthful eating, she's been able to go without even one cigarette, reports Anahad O'Conner of The New York Times.

Others have also been struck by this hard-hitting campaign, which may have prompted more than 100,000 Americans to quit smoking permanently, says a new CDC study published in The Lancet, the leading British medical journal. The CDC says an estimated 1.6 million U.S. smokers attempted to quit this past year after viewing campaign materials funded by the Affordable Care Act.

"Hard-hitting ads work," said CDC Director Dr. Tom Frieden. The agency paid approximately $50 million to produce and place the spots, the first time the federal government funded a nationwide tobacco-education ad campaign, reports Jonathan Serrie of Fox News.

"The impact is huge because a smoker costs about $2,000 more [per year] than a non-smoker, and about $1,000 more than an ex-smoker, to care for," Frieden said. "And if you do the math, this program pays for itself in a year or two in reduced health-care and societal expenditures."

The campaign also saved an estimated 300,000 years of life that smoking-related diseases would have taken, reports Brady Dennis of The Washington Post. Smoking remains the leading cause of preventable death in the United States, killing more than 1,200 Americans each day, says the CDC.

Click here for the CDC ads and other smoking-cessation resources.

Growing up on farm helps immune system, study of pigs shows

For the first time, there is conclusive evidence that growing up on a farm is good for the immune system. Researchers from the University of Bristol's veterinary sciences school have published a study showing that "spending early life in a complex farm environment" increases the number of T-cells one has, reports Sarah Muirhead of Feedstuffs. T-cells have been identified as universal regulators of immune systems, with low numbers increasing risk of developing allergies, autoimmune and inflammatory diseases. Researcher Marie Lewis said it wasn't previously known whether farm life increased immunity to allergies, or if people more prone to allergies weren't living on farms.

Piglets were used in the study since they share many aspects of human physiology, metabolism, genetics and immunity. Some of the piglets were nursed by their mother on the farm, while the others were kept in an isolator unit under hygenic conditions and fed formula milk to reflect the "extremes of environment" in which many humans are raised. Farm-raised piglets had increased levels of T-cells compared to those raised in the isolator. Lewis said it's not clear yet exactly what caused the increase in T-cells in farm-reared piglets, but said previous work shows that intestinal bacteria "plays a pivotal role." (Read more)

State health commissioner retiring after seven years in the job, fighting for public health and expanding its role

By Tara Kaprowy
Kentucky Health News

After dealing with the aftermath of 9/11, an anthrax scare, H1N1 flu, the worst ice storm in Kentucky's history and a series of budget cuts, it's been a busy decade for Dr. William Hacker at the state health department. But after 10 years at the agency, seven as its boss, Hacker will retire at the end of the month.

He is getting great reviews for his work as commissioner, which has included expanding the role of public health beyond its traditional roles, including disaster response and prevention.

"Dr. Hacker has always provided quality leadership," said Scott Lockard, president of the Kentucky Public Health Association. "He has been a great advocate for public health. He has been well respected both in state and on the national level and he will be deeply missed."

"Dr. William Hacker has been an exemplary leader for public health and has led by example with his professional and genteel leadership style," said Linda Sims, director of the Lincoln Trail District Health Department and president of the Kentucky Health Department Association. "Dr. Hacker has been instrumental in helping local health departments during budgetary challenges with guidance and support. The development of new services and screenings for children have increased under his efforts that will make a difference for many years to come."

Hacker, a native of Manchester, joined the department in February 2001 to work in the maternal and child health division. He'd practiced as a pediatrician in Corbin for 18 years and subsequently spent six years with Appalachian Regional Health Care.

Just eight months after he came on board at the health department, his role expanded drastically. "On 9/11, we were asked how many burn beds we had available in Kentucky because they felt they would be flying burn victims to us," he said. "We had never had funding to establish the ability to actually track the beds available. Public health did not have a role to play in critical health care. But they called on public health that day."

Three weeks later, suspicious white powder started appearing in the mail, and public health offices nationwide were called again. Though anthrax spores were not found in Kentucky, envelopes containing white powder were, and they needed to be tested by public-health officials.

Dr. Rice Leach, then the commissioner, asked Hacker to establish the Public Health Preparedness Branch of the Division of Epidemiology and Health Planning, marking a major shift for the department. Traditionally, public health had not been involved in incident management, which occurs when first responders are sent in to handle a crisis. "We were the backup to deal with consequence management," Hacker said. "But when you're dealing with bioterrorism, public health needs to step in. There was a lot of learning that went on between law enforcement, emergency medical services and public health. That was a cultural shift. We were forced through the natural evolution of events to step up to the plate."

In 2004, following Leach's retirement, Republican Gov. Ernie Fletcher named Hacker commissioner. He established the Kentucky Outreach and Information Network, which expanded the department's ability to reach vulnerable populations like senior citizens and people with language, hearing or motor difficulties. Partnerships are still in place with other state agencies, Family Resource Youth Service Centers, literacy programs and faith-based organizations such as the Christian Appalachian Project. "We'd say, 'Here's the message we need to get out, whether we were talking about a hot weather advisory or how long is it safe to eat food out of your refrigerator if your electricity is out," he said.

In 2005, Hurricane Katrina struck New Orleans, prompting several thousand people to come to Kentucky. "We had to figure out how to take care of these people without any resources and many times without any family connections," Hacker said. Hurricanes Gustav and Ike followed, presenting similar challenges.

The next major disaster was the 2009 ice storm. The role of public health was to provide shelter, which Hacker called "a major challenge." But emergency stockpiles obtained by the Public Health Preparedness Branch proved useful. "We use cots, satellite radios and generators that were supposed to be used for an inflatable hospital," he said. "That provided power in Elizabethtown."

Emergency stockpiles were also tapped for items like face masks in 2009-10, when people started getting sick with H1N1. "We responded efficiently because of the training we had been planning for," Hacker said. In 2006, department officials prepared extensively for a bird flu "that is still smoldering," Hacker said, but has never reached the ability to spread quickly from person to person.

In the middle of all this, the state changed governors, but not health commissioners. Democratic Gov. Steve Beshear, who took office in December 2007, appointed a new secretary of the Cabinet for Health and Family Services, but showed confidence in Hacker by keeping him as commissioner of the cabinet's Department of Public Health. "I was prepared for Gov. Beshear to select someone else, but I was very pleased when he gave me the opportunity to continue to serve," Hacker said. Apart from Leach and Dr. Carlos Hernandez, Hacker has served one of the longest terms of any commissioner in the past 40 years.

Beshear told Kentucky Health News in July 2011, "Dr. Hacker’s commitment to public health and education is unassailable, and he provided great leadership and vision for our Department of Public Health. Dr. Hacker built teams, mentored, encouraged and connected organizations and people to achieve better outcomes for Kentuckians’ health. His success is largely driven by his belief in inclusion -- that bringing together many organizations can improve health in Kentucky. Kentucky will miss him."

Beshear's retention of Hacker greatly pleased Al Smith, who had just concluded 33 years as producer and founding host of "Comment on Kentucky" on KET. A former newspaper publisher in London and Western Kentucky, Smith helped Hacker campaign for a comprehensive hospital to serve Corbin and London. "He was ahead of his time, as usual, and we lost the political game," Smith recalled. "Fortunately, his great gifts have been appreciated by the state and other health providers who have kept him in leadership for many years. I hope there will be other opportunities for his influence and service at another time. . . . In or out of public service, Dr. Bill Hacker is a leader who always seeks the best for Kentucky."

Asked his biggest accomplishment, Hacker named two: leaving behind a capable team and establishing the Preparedness Branch, which he said is now deeply embedded. "I have a personal relationship with senior FBI agents that did not exist before," he said. "We have a very close partnership with emergency management officials. And we're close with the Department of Agriculture because of the correlation between animal diseases and human diseases. All those partnerships have positioned Kentucky's government entities to be more responsive."

That responsiveness, however, has a lot to do with funding, which Hacker said is his biggest worry, because public health tends to be invisible. "If you ask, most people think public health just takes care of poor people. We, in fact, take care of all forms of people. It's just we do our jobs well and so it's invisible to those folks unless they need a public health service."

Already, Hacker has dealt with several rounds of budget cuts and is worried that "political leaders and the public don't really understand the impact of what the future may look like" with a less well funded public health system. "It could mean slower response to diseases, slower response to disasters, less cervical cancer screening, less prenatal care. There's a whole host of services being provided but they cost money," he said.

Still, though it's not without concern for the future of the department, Hacker, 64, said it's time to head home. He will continue to live in Lexington. "My wife has some health problems and for 44 years she's made sacrifices to support my career. I think the time has come to reverse the equation," he said. "My decision to leave was a difficult one because I love the mission of public health. But it became clear to me that this was the right time to transition from employment to retirement. I will continue to support the mission of public health in any way I can contribute."

Dr. Steve Davis, longtime deputy commissioner of the department, will take over as interim commissioner Aug. 1. He called Hacker "a good doc and a good man. Simply put, we have been blessed to have him for many years."

Fight is on against mosquitoes, West Nile virus after flooding

The fight is on to rid Western Kentucky of a mosquito infestation  worsened by recent flooding. Treatment to kill adult mosquitoes began Wednesday night, The Gleaner of Henderson reports.

The effort is partly to prevent the spread of the West Nile virus, a potentially serious illness. Mild infection can result in fever, headache, body ache and a skin rash. Severe infection, which affects about 1 in 150 infected people, can lead to high fever, disorientation, sleepiness and even coma, paralysis and death. Mosquitoes can transmit the infection to humans with a bite. (Centers for Disease Control and Prevention diagram)

The state's plan is a two-part process, killing adult mosquitoes and their larvae. It uses aerial spraying over 700,000 acres in Western Kentucky, concentrating on areas along or near waterways where flooding was most problematic. Planes will spray from dusk until after midnight until treatment is complete. Afterward, ground crews with the Transportation Cabinet will treat against mosquito larvae in standing water. The state Department of Agriculture will also spray ditch lines along roads. Chemicals used in the treatments are only harmful to mosquitoes, gnats and black flies, a state press release reads. It is safe for humans, pets and livestock.

Residents are asked to eliminate standing water in containers on their property and wear insect repellent and long-sleeved clothing. (Read more)