Marin County public health officials have quarantined two senior residential care centers and a preschool because of an outbreak of a flu-like illness.

The suspected culprit is norovirus, a gastrointestinal illness that causes nausea, vomiting, diarrhea and stomach cramps. Most people who are infected recover in two to three days without hospitalization and with no long-term health effects. But deaths have occurred in some cases. The greatest risk is dehydration because of vomiting and diarrhea in the very young and elderly.

So far, 36 people, including patients and staff members, have fallen ill at Aegis Living of San Rafael at 111 Merrydale Road, which has 70 beds, said Shanna Cronan, a nurse speaking on behalf of the Marin County Division of Public Health Services. At Aegis Living in Corte Madera at 5555 Paradise Drive, 37 people have become sick, Cronan said. The quarantine at the San Rafael center might be lifted Tuesday.

Cronan said Public Health Services didn’t learn of the outbreak at the preschool until Monday, even though it began on Jan. 13. So far, 16 children and adults have become ill at the preschool, which she declined to identify.

She said not enough test samples have been collected yet to determine the cause of any of the outbreaks. Norovirus is suspected, however, based on the symptoms being displayed.

The outbreak at the San Rafael facility began Jan. 14, and the first illness at the Corte Madera facility occurred on Thursday, Cronan said. Both are owned by Aegis Senior Communities, a limited liability corporation.

Cronan said Aegis waited until Friday to notify Public Health Services of both outbreaks. She said notification should have occurred sooner because facilities are required to contact the county within 48 hours once they have two or more “cases with acute onset of vomiting or diarrhea, or one lab-confirmed case.”

A Novato resident who has a family member living at Aegis Living of San Rafael said the management there never notified her of the outbreak. The woman, who asked that she not be identified, said she learned of the quarantine only when the family member phoned her.

Mary Crowe, the executive director of Aegis Living of San Rafael, said relatives of the people living at the San Rafael center were notified of the outbreak on Friday.

“We are taking preventative measures, which means we are asking people not to visit. It’s very standard,” Crowe said. “We haven’t had any new cases in 24 hours so I think we’re pretty clear.”

Crowe said the two Aegis facilities do share some employees. “There are a couple that work part-time that go back and forth,” she said. Diane Savard, the administrator of Aegis Living in Corte Madera, was unavailable for comment.

Rebecca Ng, chief of Marin County’s Division of Environmental Health Services, said she first learned of the three new outbreaks when she was contacted by the Independent Journal on Monday. Ng said normally her department is notified immediately when gastrointestinal illnesses occur so the facilities’ kitchens can be inspected for possible sources of contamination. But Marin County’s public health officer, Dr. Jason Eberhart-Phillips, said he personally sent Ng an email on Friday informing her of the outbreaks at the Aegis facilities.

Environmental Health Services was not notified in November when a norovirus outbreak at Country Villa Novato Healthcare Center in Novato resulted in at least 80 residents and staff members becoming ill. Cronan said the norovirus outbreak at Country Villa was one of three at Marin County nursing homes that month; each resulted in a county-mandated quarantine. But Cronan would not identify where the other outbreaks occurred.

Eberhart-Phillips said that if the county were to make public the names of facilities where outbreaks occur, managers there would be less likely to notify the county. Officials, however, have confirmed the sites of local outbreaks when specifically asked about them by the Independent Journal.

Pat McGinnis, executive director of California Advocates for Nursing Home Reform, a statewide nonprofit advocacy organization, said the county’s refusal to identify the locations of all outbreaks “is very unusual. It’s a county public health department. It’s supposed to be public information.”

Contact Richard Halstead via e-mail at

GP urges people to get flu jab

8:00am Monday 24th October 2011

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PEOPLE in Yeovil and South Somerset are being urged to get their flu vaccines now to reduce the risk of them getting this highly infectious disease during the winter.

Seasonal flu vaccinations are currently being offered at GP surgeries across the county.

Somerset GPs want to see patients in “at risk” categories coming forward to take up the offer of a free flu jab as this offers the best possible protection to vulnerable patients and helps reduce the risk of an outbreak of flu this winter.

a bout of flu can be particularly serious for the elderly and those with long-term health conditions, with complications associated with the disease seriously affecting people with lung conditions such as asthma.

Dr Harry Yoxall, a Somerset GP and secretary of the Somerset Local Medical Committee, said: “I am concerned that many people in the “at risk” category still fail to take the offer of a free flu vaccination each year.

“If you are elderly, pregnant or have an existing medical condition then you will be more susceptible to the effects of flu and have an increased risk of developing more serious illnesses such as bronchitis and pneumonia, or making your existing health conditions even worse. In the worst possible scenarios, seasonal flu can result in a stay in hospital or even death.”

Flu is much worse than a bad cold and you may need to stay in bed for a few days if you have flu.

The symptoms will be more serious than a cold and include fever, chills, headaches and aching muscles. You can often get a cough and sore throat at the same time. Flu is caused by viruses so asking your family doctor for antibiotics won’t help treat it.

If you are over 65 or have any of the following conditions – heart problems; chest complaints or breathing difficulties; kidney disease; lowered immunity due to disease or treatment; liver disease; had a stroke; diabetes; a neurological condition; a problem with your spleen – you should see your GP Practice for a seasonal flu vaccination.

Dr Yoxall added: “It is best to have the seasonal flu vaccination in the autumn before any outbreaks of seasonal flu.

“Remember that you need it every year, so don’t assume that you don’t need another vaccination because you had one last year. The flu jab is free so make an appointment with your GP surgery.”

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NPS Pharmaceuticals, Inc. (Nasdaq: NPSP) a specialty pharmaceutical company developing innovative therapeutics for rare gastrointestinal and endocrine disorders, today announced the randomization of the last patient in REPLACE, its Phase 3 registration study of NPSP558, a bioengineered form of human parathyroid hormone. REPLACE is a double-blind, placebo-controlled study evaluating the use of NPSP558 as hormone replacement therapy in adult patients with hypoparathyroidism. A total of 135 patients were randomized in this study.

“This is an important milestone in our NPSP558 pivotal study in hypoparathyroidism and we look forward to reporting top line results by the end of this year,” said Francois Nader, MD, president and chief executive officer of NPS Pharmaceuticals. “There are currently no approved treatments for hypoparathyroidism, a disease that can cause serious bone, muscular and neurological symptoms. Current treatment approaches are palliative and can lead to long-term health risks. As a replica of natural parathyroid hormone 1-84, NPSP558 has the potential to address this unmet need by treating the underlying cause of the disorder rather than just managing the symptoms.”

NPS believes positive results from REPLACE will enable it to file for U.S. marketing approval in 2012 for NPSP558 in hypoparathyroidism.

About the REPLACE Study

REPLACE is a randomized, double-blind, dose escalating, placebo-controlled Phase 3 registration study to investigate the use of NPSP558 for the treatment of adults with hypoparathyroidism at more than 30 sites in North America and Europe.

The study consists of an average 10-week screening and stabilization period followed by a 24-week treatment period marked by randomization (2:1) to 50µg once daily NPSP558 or placebo. Following randomization, patients undergo staged reductions in calcium and vitamin D supplementation, while maintaining stabilized serum calcium. if needed, step-wise up-titration of study drug (NPSP558 or placebo) to a dose of 75 µg and then if necessary to 100 µg in patients over a six to eight week period will be performed. Patients will continue on their final dose through week 24. A follow-up period without study drug will last from week 24 to week 28.

The primary efficacy endpoint of REPLACE is to demonstrate by Week 24 at least a 50 percent reduction from baseline of oral calcium supplementation and active vitamin D metabolite/analog therapy and a total serum calcium concentration that is normalized or maintained compared to baseline (=7.5 mg/dL).

About Hypoparathyroidism

Hypoparathyroidism is a rare disorder in which the body produces insufficient levels of parathyroid hormone, the principal regulator of calcium and phosphorus. When the body has too little parathyroid hormone, blood calcium levels drop and phosphorus levels increase, which can cause muscular and neurological symptoms, as well as bone impairments. There is no approved treatment for hypoparathyroidism. it is one of the few remaining hormone deficiency syndromes in which replacement therapy using the native hormone is not clinically available. Hypoparathyroidism is currently managed with large doses of oral calcium and vitamin D supplementation to raise the calcium levels in the blood and reduce the severity of symptoms. Over time, calcium may build up in the body and result in serious health risks, including calcifications in the kidneys, heart or brain.

NPS has estimated that approximately 60,000 to 65,000 patients suffer from hypoparathyroidism in the U.S.

About NPSP558 (parathyroid hormone 1-84 [rDNA origin] injection)

NPSP558, a bioengineered replica of human parathyroid hormone 1-84, is being evaluated in a Phase 3 registration study, known as REPLACE, as the first hormone replacement therapy for the underlying cause of hypoparathyroidism. because it mimics the action of natural parathyroid hormone, NPSP558 has the potential to treat hypoparathyroidism and offer a more physiological treatment outcome than what is available with existing treatments.

Results from an investigator-initiated Phase 2 open-label proof-of-concept study demonstrated that NPSP558 potentially can be used as a therapeutic agent in hypoparathyroidism effectively and safely. The study showed that NPSP558 treatment in hypoparathyroidism significantly reduces supplemental calcium and 1,25-dihydroxyvitamin D requirements while maintaining serum calcium levels. Data were published in January 2010 in the international peer-reviewed journal Osteoporosis International.

NPS has received orphan drug status for NPSP558 for the treatment of hypoparathyroidism. The company’s partner Nycomed markets PTH (1-84) ex-US as Preotact® for the treatment of osteoporosis in post-menopausal women at high risk of fractures.

About NPS Pharmaceuticals

NPS Pharmaceuticals is an outsourcing-based development company focused on bringing biopharmaceuticals to patients with rare disorders and few, if any, therapeutic options. The company is advancing two Phase 3 registration programs, GATTEX® (teduglutide) in short bowel syndrome (SBS) and NPSP558 (parathyroid hormone (1-84) [rDNA origin] injection) in hypoparathyroidism. NPS complements its proprietary programs with a royalty-based portfolio of products and product candidates that includes agreements with Amgen, Kyowa Hakko Kirin, Nycomed, and Ortho-McNeil Pharmaceutical.

“NPS”, “NPS Pharmaceuticals”, and “GATTEX” are the company’s registered trademarks. all other trademarks, trade names or service marks appearing in this press release are the property of their respective owners.

Statements made in this press release, which are not historical in nature, constitute forward-looking statements for purposes of the safe harbor provided by the Private Securities Litigation Reform Act of 1995. these statements are based on the company’s current expectations and beliefs and are subject to a number of factors and uncertainties that could cause actual results to differ materially from those described in the forward-looking statements. Risks associated to the company’s business include, but are not limited to, the risks associated with any failure by the company to successfully complete its preclinical and clinical studies within the projected time frames or not at all, the risk of not gaining marketing approvals for GATTEX, the risks associated with the company’s strategy, as well as other risk factors described in the company’s periodic filings with the U.S. Securities and Exchange Commission, including its Annual Report on Form 10-K and Form 10-Qs. all information in this press release is as of the date of this release and NPS undertakes no duty to update this information.

Business Wirebusinesswire.com/

Last updated on: 01/03/2011 14:00:03

Menopause marks the end of a woman’s menstrual cycling and fertility and is a condition that all women experience as they age. it occurs when the ovaries cease producing oestrogen and progesterone, two necessary hormones for a woman’s reproductive cycle to function.

Menopause typically occurs in a woman’s late forties or early fifties. The decreasing levels of oestrogen associated with menopause may cause more distressing symptoms that include:

- Decreased sex drive

- Racing heart (palpitations)

- Vaginal dryness and soreness

- Bone thinning (osteoporosis)

Hot flashes are the most frequent symptom of menopause and perimenopause. Soy products are high in isoflavones (phytoestrogen) and work in the body like a weak form of oestrogen that may help relieve symptoms. for some women, lowering their cholesterol level may help as it has may relieve hot flashes and night sweats.

Traditional Asian diets are high in soy, ranging from 40 to 80mg of isoflavones each day.

The average person in the US eats very little soy – less than 3mg of isoflavones each day.

It is recommended to consume a range of 40 to 80mg of isoflavones per day for adequate relief.

Five nutrition tips that can prevent long-term health risks associated with menopause

1. OSTEOPOROSIS

hdGet enough calcium. an adequate intake of calcium for women aged 51 and older is 1,000 (Thai DRI) _1.2g per day. Eating and drinking two to four servings of dairy products (300mg of calcium per serving) and calcium-rich foods such as sardines, canned salmon, broccoli and legumes will help ensure enough calcium in a daily diet. also soy isoflavones help promote better bone health and have a positive effect on bone density.

2.CORONARY ARTERY DISEASE

hdReduce foods high in fat. Fat should provide 30% or less of your total daily calories. also, limit saturated fat to less than 10% of your total daily calories. Saturated fat raises cholesterol and increases your risk of heart disease. Saturated fat is found in fatty meats, whole milk, ice cream, and cheese. Limit cholesterol intake to 300mg or less per day. also try to limit your intake of trans fat, found in vegetable oils, many baked goods and some margarines. Trans fat also raises cholesterol and increases your risk of heart disease.

3.EAT FRUITS AND VEGETABLES

hdInclude at least two to four servings of fruits and three to five servings of vegetables in your daily diet to get adequate fibre, vitamins and minerals.

4.USE SALT IN MODERATION

hdToo much sodium in a diet has been linked to high blood pressure. Limit adding salt, fish sauce and soy sauce to food and minimise cured foods (bacon and ham), foods packed in brine (pickles, pickled vegetables, olives, sauerkraut), and condiments (mustard, horseradish, ketchup, barbecue sauce).

5.LIMIT ALCOHOL INTAKE

hdWomen should limit their consumption of alcohol to one drink a day or less. one drink is a glass of wine (150ml), can of beer (360ml) or glass of whisky (45ml).

Molruedee Jitkhaw is a dietitian at BNH Hospital.

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