Listeria death toll now at 23, making outbreak deadliest in 25 years

October 13th, 2011 by admin

By Ryan Jaslow

cantaloupe, listeria
(Credit: Joe Raedle/Getty Images)
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(CBS/AP) The Listeria outbreak from cantaloupes is now the deadliest foodborne illness outbreak in the U.S. in more than 25 years.

Pictures: 10 dangerous but common food safety mistakes

The CDC announced Wednesday that 23 people have died from listeriosis, while another 116 have been sickened. Not since 1985, when Listeria from Mexican-style soft cheeses killed 52 people, has a foodborne illness outbreak been this deadly in America. The current death toll also surpassed a 1998 Listeria outbreak linked to processed meats that killed 21 people.

Officials say the tainted cantaloupes from Jensen Farms in Holly, Colo., should be off store shelves by now, as they were recalled mid-September and their shelf life is about two weeks. But the number of deaths may continue to grow. Symptoms of listeriosis can take up to two months to appear.

The CDC on Wednesday confirmed two more deaths in Louisiana. Other deaths have been reported in Colorado, Indiana, Kansas, Maryland, Missouri, Nebraska, New Mexico, New York, Oklahoma, Texas and Wyoming.

Listeria illnesses have been reported in Alabama, Arkansas, California, Colorado, Idaho, Illinois, Indiana, Iowa, Kansas, Louisiana, Maryland, Missouri, Montana, Nebraska, New Mexico, New York, North Dakota, Oklahoma, Oregon, South Dakota, Texas, Virginia, West Virginia, Wisconsin and Wyoming.

FDA investigators said that Colorado health officials found Listeria in cantaloupes taken from grocery stores and from a victim’s home that were grown at Jensen Farms. Matching disease strains were found on equipment and cantaloupe samples at Jensen Farms’ packing facility in Granada, Colo. FDA officials have said they were looking at the farm’s water supply and possible animal intrusions among other things to figure out the source of the problem. Listeria grows in moist and muddy conditions, and the bacteria are often are carried by animals.

Jensen shipped the cantaloupes to about half the states, but added that it wasn’t sure where the cantaloupes went because they have been sold and resold. Some companies may be unaware that they bought or distributed the tainted fruit.

Listeria is more deadly than other well-known pathogens such as salmonella and E. coli. While most healthy adults can consume Listeria with no ill effects, it can kill the elderly, those with compromised immune systems, and unborn children of pregnant women. The CDC said the median age of those sickened is 78, and most people who are ill are over 60. The CDC said it is also aware of one miscarriage linked to the outbreak.

Colorado has the most illnesses with 34, while Texas has reported 17.

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Arthritis pain: Do’s and don’ts.

August 24th, 2011 by admin

Arthritis Remedy Site image

Will physical activity reduce or increase your arthritis pain? Get tips on exercise and other common concerns when coping with arthritis symptoms and arthritis pain.

By Mayo Clinic staff

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You get all kinds of advice about exercise, medication and stress reduction, but how do you know what will work best for you? Here are some do’s and don’ts to help you figure it out.

Basics

Whatever your condition, you’ll have an easier time staying ahead of your pain if you:

  • Talk to your doctor about all your symptoms, arthritis related or not. Sometimes seemingly unrelated problems are, in fact, connected.
  • Give your doctor complete information about all your medical conditions, not just arthritis.
  • Ask your doctor for a clear definition of the type of arthritis you have.
  • Find out whether any of your joints are already damaged.

Everyday routines

Do some gentle exercise in the evening; you’ll feel less stiff in the morning. When you’re technically doing nothing — watching TV or sitting at your desk, for instance — be sure to:

  • Adjust your position frequently.
  • Periodically tilt your neck from side to side, change the position of your hands, and bend and stretch your legs.
  • Pace yourself. Take breaks so that you don’t overuse a joint and cause more pain.
Click here to read page 2 > Arthritis pain: Do’s and don’ts.
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When chronic illness strikes: Tips on talking to family and close friends

May 26th, 2011 by admin

by Toni Bernhard, JD

In the summer of 2001, I was preparing to begin my 19th year on the faculty of U.C. Davis School of Law. Then I got sick with what the doctors thought was an acute viral infection. I have yet to recover.

Being diagnosed with a chronic illness or condition can take a toll on your relationships, partly because all of the affected parties are confused and scrambling to adjust to this drastic and unexpected change in your daily life. It’s a crisis—for you and for those who are close to you.

Here are four tips to help you communicate more skillfully with loved ones when chronic illness becomes an inescapable part of your life.

  1. Get help from a neutral third party. Often the best way to educate family and close friends about your diagnosis is to use a third party source because it takes the emotional component out of the equation. There are online organizations and associations devoted to every chronic illness or condition. Once you find them, you can forward links or print out pages for loved ones to read. If you have a book about your illness, photocopy the chapters that cover what you’d like your loved ones to know about your new life. (I did this for my close friends, attaching a short explanatory note to two chapters that I copied.)
  2. Write a letter. If loved ones are not being supportive even after you’ve tried to educate them about your illness, write a letter to them. Describe what your day is like now, and express how you feel about this unexpected change in your life. A friend of mine wrote a letter like this to her mother when, despite their many conversations about her illness, her mother persisted in saying things like, “If you’d just get up off the couch and go out and exercise, you’ll be fine.” The letter transformed their relationship. Now her mother is one of her main sources of support.
  3. Find non-illness related subjects to talk about. I had to learn how talk to others as a person with a chronic illness. At first, I assumed my family and close friends would want to know everything about my illness. After each doctor’s visit, I’d send them a long email describing the appointment in detail, medical jargon included. I’d get back a supportive sentence or two. It took several years for me to realize that my relationship with them would be more enjoyable and richer if I didn’t always talk about my illness. Now I ask about their lives and talk about new interests that I’ve developed. It provides all of us with a much needed respite from thinking about my illness all the time.
  4. In the end…accept their limitations. Some family and close friends may never accept this change in your life. Try to recognize that this inability to accept you as you are now is about them, not you. Your medical condition may trigger their own fears about illness and mortality. You can’t always fix how others think of you or treat you, but you can protect yourself from allowing their lack of understanding to exacerbate your symptoms. The best way to protect yourself is to cultivate compassion for them. If you can learn to wish them well despite their inability to support you, you can free yourself from the mental suffering that arises from your desire for them to be different than they are. The physical suffering that accompanies chronic illness is difficult enough without adding mental suffering to it.

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Everyone (including yourself) needs time to let this life-changing circumstance sink in. Hopefully, these four tips will make the road to acceptance less stressful.

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Second Chance at Life for Adult Stem Cell Transplant Patient

February 17th, 2011 by admin

by David Prentice

An update on the City of Hope’s 10,000th bone marrow adult stem cell transplant. The patient, now identified as 51-year-old William Fuller, was released from the hospital last week. The father of three, a small-business owner, was born in Belize and came to the U.S. in 1982. When he had his adult stem cell transplant on Jan. 13, 2011, his nurse wished him “Happy Birthday,” signaling the beginning of his new life.

According to Dr. Stephen J. Forman at City of Hope:

“Mr. Fuller is the poster child for what we do. There are thousands of other people like him who have been helped because a donor came forward to provide lifesaving stem cells that allowed us to do a transplant and hopefully cure the disease. Every patient who gets through a transplant here is the beneficiary of a lot of laboratory work and hard thinking that’s gone into trying to solve the problem – how to best cure the cancer in the safest way possible.”

Dr. Forman noted many patients view their adult stem cell donors as new members of their family, and often develop lifelong relationships. “They are ‘blood relatives,’” he said.

Mr. Fuller credited his sister, Karen Hyde, as being instrumental in arranging bone marrow drives in California, Florida and New York with the help of “Be the Match,” the national marrow donor program.

Adult stem cells continue to save thousands of lives every year.

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Weight control: What the research says

December 22nd, 2010 by admin
Weight Control - Mayo Clinic nutritionists

Jennifer Nelson, M.S., R.D. and Katherine Zeratsky, R.D.


Anyone who has begun or is on a weight loss journey knows that weight control — losing weight and keeping it off — can be a daily challenge. Weight control is a complex. It’s about living a healthy lifestyle and making smart choices, despite the many hurdles life throws at you, whether they’re physical, emotional or social.

It’s easy to feel overwhelmed when you’re looking for advice on weight control. Every week a new diet appears on bookshelves, magazine racks or online. Even when you go to the scientific and medical journals, there’s debate about which diet is best for weight control. Teasing out all the variables can frustrate even the most dedicated researcher. So I thought I’d cut to the chase and offer some practical advice on weight control.

The bottom line really is that you must control calories through portion control, appropriate food choices and physical activity. However, there are few weight control tricks that can be culled from the diet research:

  • Eat some protein. Protein is cited as the most satiating nutrient. No need to overdo it, but include 1 to 3 ounces (28 to 85 grams) of a protein-rich food at meals. Protein, beyond its basic function of building and repair, moderates the rise of blood glucose. This steadies your hunger and energy levels.
  • Go low on the glycemic index. Foods with a low glycemic index — most fruits, veggies and whole grains — are part of any healthy diet. They contain fiber and water that give them bulk without the calories, making them filling foods. These properties also play a positive role in your body’s metabolism and insulin response.
  • Choose the right carbs. Carbs are packed with nutrients that are essential to feeling good each day, and they likely play a strong role in disease prevention. Most of your choices here should be whole foods or as close to it as possible.
  • Be selective about fats. Fat plays a key role in our health. Fat also aids hunger control because it is slowly digested. Moderating the amount you eat will reduce your calories. Choosing healthier fats — nuts, oils and avocado, for instance — instead of saturated fats can improve your heart health and may have a role preserving good mental and physical health.

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How pharmacists address the healthcare needs of patients today

October 28th, 2010 by admin

by Thomas Sullivan

In addition to outlining patient’s medications, and teaching them what times of day to take the drugs that will help control their specific disease, pharmacists are now taking on a new role to address the growing healthcare needs and demands of Americans, according to a recent article in the New York Times.

For example, at Barney’s Pharmacy in Augusta, Ga., the pharmacy offers classes at the store for patients once a month on how to manage diseases with drugs, diet and exercise. This new service, according to the Times, reflects the expanding role of the nation’s pharmacists in ways that may benefit their customers and also represent a new source of revenue for the profession.” In fact, “some health plans are even paying pharmacists to monitor patients taking regular medications for chronic illnesses like diabetes or heart disease.” And these pharmacists don’t just dispense drugs to patients, they also partner with patients to improve their health as well.”

Another role that pharmacists are playing at independent drugstores and some national chains like Walgreens and the Medicine Shoppe and even supermarkets like Kroger, is “by working with doctors and nurses to care for people with long-term illnesses.”

Pharmacists are also “being enlisted by some health insurers and large employers to help address the fact that “as many as half of the nation’s patients do not take their medications as prescribed, which ends up costing nearly $300 billion a year in emergency room visits, hospital stays and other medical expenditures.”

In their unique role, pharmacists also maintain the “front line of detecting prescription overlap or dangerous interaction between drugs and for recommending cheaper options to expensive medicines.

As a result of the numerous responsibilities pharmacists already carry out, pilot programs, such as the one started by Dr. Andrew Halpert, senior medical director for Blue Shield of California, are attempting to show that pharmacists “could do as well and better than a physician” for less money. Specifically, the program seeks to address the shortage of primary care doctors by using the education, expertise, free time and plain-spoken approach pharmacists use to talk to patients at length about what medicines they are taking and to keep close tabs on their well-being as a way.

“Some health insurers and large employers who pay for programs called medication therapy management, which typically involve face-to-face sessions between pharmacists and patients in retail stores or clinics”, have already taken this kind of approach. Programs such as these pay pharmacists to track patients, monitor cholesterol or blood glucose levels, or prod customers to change their diets or exercise.

Since 2006, some “Medicare plans started covering medication therapy management programs, paying $1 to $2 a minute to pharmacists to review patients’ medicines with them, and in 2010, about one in four people covered by Medicare Part D prescription drug plans will be eligible.”

Pharmacists are also advising patients about medication through grants and such as the Wisconsin Pharmacy Quality Collaborative, which standardizes medication therapy management and ensures quality care. Similarly, Humana, which has offered pharmacists medication advising for a few years, is studying a third of 62,000 pharmacies in its network to see “whether a pharmacist seeing a patient in person has more impact than a phone call.”

According to the Times, the result of these new services “has spawned a new industry of medication therapy management companies to run clinical pharmacy programs for health insurers, contracting with pharmacists and tracking the financial and health outcomes of their services.” And results so far have been positive. For example one recent study financed by GlaxoSmithKline, tracked 573 people with diabetes (30 employers in 10 cities) who took part in at least two sessions with pharmacists who helped them track their blood sugar, blood pressure and cholesterol levels and offered diet and exercise advice. The results of the study showed that after a year, blood pressure, blood sugar and cholesterol levels typically improved — and saved an average $593 a person on diabetes drugs and supplies.

While some groups may be concerned about the proper role pharmacists should play, as Michelle A. Chui, an assistant professor at the University of Wisconsin School of Pharmacy pointed out, “pharmacists do not want to compete with doctors, they merely want to provide more information “so the physician has a more in-depth picture.”

Consequently, pharmacists who provide more education and information to share with health care providers and patients should be encouraged because it gives patients a better chance to understand and follow medication directions in a consistent manner. As a result, using education companies, which teaches other pharmacies how to introduce in-store services, should also be encouraged because as the owner of Barney’s Pharmacy noted, when pharmacists “get involved with chronic care patients, their outcomes improve.”

Accordingly, with 31 million more patients entering the health care system through government programs, and with populations getting older and living longer, the number of prescriptions will grow exponentially. Not only will we need companies and funding to create and discover the drugs to provide to this influx of people, we will also need pharmacists to help fill prescriptions.

Allowing our pharmacists to continue their role in educating patients will help ensure that patients follow their medical therapy and management, which will save lives and money

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ADHD Diet: Do food additives cause hyperactivity?

October 12th, 2010 by admin

ADHD Diet

ADHD Diet?

Question

I have a son with attention-deficit/hyperactivity disorder (ADHD). What does the research say about the relationship between food additives and ADHD?

Answer from  Mayo Clinic child psychiatrist John E. Huxsahl, M.D.

There’s no evidence that food additives cause attention-deficit/hyperactivity disorder (ADHD), but an increasing number of studies show that certain food colorings and preservatives may cause or worsen hyperactive behavior in some children. Because several studies looked at a combination of food additives and their possible effects on hyperactivity and ADHD, it isn’t clear which additives may affect behavior.

Food additives that may increase hyperactive behavior include:

  • Sodium benzoate
  • FD&C Yellow No. 6 (sunset yellow)
  • D&C Yellow No. 10 (quinoline yellow)
  • FD&C Yellow No. 5 (tartrazine)
  • FD&C Red No.40 (allura red)

FD&C Yellow No. 5, used in beverages, candy, ice cream, custards and other foods, may be more likely to cause reactions than other additives. The Food and Drug Administration requires that FD&C Yellow No. 5 be clearly labeled on food packaging along with other ingredients. But many colorings and food additives don’t require similar labeling, so it can be difficult to tell whether a food contains artificial coloring or other additives. One rule of thumb is that brightly colored processed foods are most likely to contain one or more coloring additives.

More research is needed regarding whether limiting certain foods helps prevent hyperactivity and ADHD symptoms. If you notice that a certain food causes a change in your child’s behavior, you may want to try eliminating it from your child’s diet to see if it makes a difference. However, consult with your child’s doctor before putting your child on a limited diet. A diet that eliminates too many foods can be unhealthy because it may lack necessary vitamins and nutrients.

The approach for your child’s overall health and nutrition is a diet that limits sugary and processed foods and is rich in fruits, vegetables, grains and healthy fats such as omega-3 fatty acids found in fish, flaxseed and other foods.

References

  1. McCann D, et al. Food additives and hyperactive behaviour in 3-year-old and 8/9-year-old children in the community: A randomised, double-blinded, placebo-controlled trial. The Lancet. 2007;370:1560.
  2. Bateman B, et al. The effects of a double blind, placebo controlled artificial food colourings and benzoate preservative challenge on hyperactivity in a general population sample of preschool children. Archives of Disease in Childhood. 2004;89:506.
  3. Schab DW, et al. Do artificial food colors promote hyperactivity in children with hyperactive syndromes? A meta-analysis of double-blind placebo-controlled trials. Journal of Developmental and Behavioral Pediatrics. 2004;6:423.
  4. Food ingredients and colors. U.S. Food and Drug Administration. http://www.fda.gov/Food/FoodIngredientsPackaging/ucm094211.htm. Accessed Sept. 24, 2009.
  5. Weber W, et al. Complementary and alternative medical therapies for attention-deficit hyperactivity disorder and autism. Pediatric Clinics of North America. 2007;54:983.

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Allergan To Pay $600 Million To Settle Charges Related To Botox

September 1st, 2010 by admin

DOW JONES NEWSWIRES

Allergan Inc. (AGN) said it has agreed to pay the U.S. government $600 million to settle criminal and civil charges related to U.S. sales and marketing of Botox.

The charges involve alleged marketing of the antiwrinkle treatment, best known for its use in cosmetic procedures, for uses not approved by the Food and Drug Administration, including headache, pain, spasticity and juvenile cerebral palsy. The product accounts for about a third of Allergan’s revenue and in the latest quarter saw sales grow 7% to $360.5 million.

The drug maker agreed to plead guilty to a misdemeanor “misbranding” charge, which indicates its labeling didn’t contain adequate directions for the treatment’s intended uses. Misbranding is known as a strict liability offense and doesn’t imply false or deceptive conduct. The company will pay $375 million in connection with the criminal settlement.

Allergan also said it has also agreed to pay $225 million to resolve civil claims asserted by the Justice Department under the civil False Claims Act.

The company expects to record fourth-quarter pretax charges of $610 million to $615 million in connection with the settlement.

“This settlement is in the best interest of our stockholders as it resolves all matters at issue in the investigation, avoids substantial costs of litigation, as well as the substantial risks to Allergan associated with government enforcement action in these matters, and permits us to focus our time and resources on productively developing new treatments for patients and the medical community,” said Douglas S. Ingram, Allergan’s executive vice president.

As part of the deal, Allergan will pay for third-party monitoring for five years of the company’s compliance efforts.

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National Institutes of Health announces 5 Botanical Research Centers

August 31st, 2010 by admin

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Studies of the safety, effectiveness, and biological action of botanical products are major focuses for the five dietary supplement research centers selected to be jointly funded by the Office of Dietary Supplements (ODS) and the National Center for Complementary and Alternative Medicine (NCCAM), two components of the National Institutes of Health. The NIH’s National Cancer Institute is co-supporting two of the five centers.

The competitive awards, approximately $1.5 million each per year for five years, were made to Pennington Biomedical Research Center, Baton Rouge, La.; University of Illinois at Chicago; University of Illinois at Urbana-Champaign; University of Missouri, Columbia; and Wake Forest University Health Sciences, Winston-Salem, N.C.

These five interdisciplinary and collaborative dietary supplement centers, known as the Botanical Research Centers (BRC) Program (http://ods.od.nih.gov/Research/BRCProgram), are expected to advance understanding of how botanicals may affect human health. “Eventually, the program may provide data that translates to new ways to reduce disease risk,” explained Paul M. Coates, Ph.D., director of ODS. “Until then, the research from these centers will help the public make informed decisions about botanical dietary supplements.”

“Botanicals are usually complex mixtures of many active constituents,” said Josephine P. Briggs, M.D., director of NCCAM. “This complexity poses some unique research challenges that these centers are well positioned to address.”

The 2007 National Health Interview Survey shows that about 18 percent of adults reported taking a non-vitamin, non-mineral, natural product, spending about $15 billion on the purchase of these products. These products contain a dietary ingredient intended to supplement the diet other than vitamins and minerals, such as single herbs or mixtures.

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FDA Approves Expanded Uses for Gardasil to Include Preventing Certain Vulvar and Vaginal Cancers

September 15th, 2008 by admin

FDA News

FOR IMMEDIATE RELEASE
September 12, 2008

Media Inquiries:
Karen Riley, 301-827-6242
Consumer Inquiries:
888-INFO-FDA

The U.S. Food and Drug Administration today announced the approval of the vaccine Gardasil for the prevention of vaginal and vulvar cancer caused by Human Papillomavirus (HPV) types 16 and 18 in girls and women ages 9 to 26. These two HPV types cause 70 percent of cervical cancers, and are known to also cause some vulvar and vaginal cancers, but the percentages are not well defined.

“There is now strong evidence showing that this vaccine can help prevent vulvar and vaginal cancers due to the same viruses for which it also helps protect against cervical cancer,” said Jesse L. Goodman, M.D., M.P.H., director of the FDA’s Center for Biologics Evaluation and Research. “While vulvar and vaginal cancers are rare, the opportunity to help prevent them is potentially an important additional benefit from immunization against HPV.”

The FDA originally approved Gardasil in 2006 for girls and women ages 9 to 26 for the prevention of cervical cancer caused by HPV types 16 and 18, precancerous genital lesions caused by HPV types 6, 11, 16, and 18 and genital warts caused by HPV types 6 and 11.

HPV includes more than 100 related viruses and more than 30 types can be transmitted via sexual contact. According to the U.S. Centers for Disease Control and Prevention, HPV is the most common sexually transmitted infection in the United States with 6.2 million Americans becoming infected with genital HPV each year.

For most women, the body’s own defense system will clear HPV, thereby preventing serious health problems. However, some HPV types can cause abnormal cell growth in areas of the cervix, vagina, vulva, and other areas that years later may turn into cancer.

Regarding the prevention of vulvar and vaginal cancer, Gardasil’s manufacturer, Merck & Co. Inc., followed more than 15,000 participants from the original studies for about two additional years. Approximately half had received Gardasil as part of the original study—the other half did not receive Gardasil and served as a control group.

Among females who tested negative for HPV types 16 or 18 at the start of the study, Gardasil was highly effective in preventing these types of HPV-related precancerous vulvar and vaginal lesions, which are considered to be the precursors for cancer. In the control group that did not receive the vaccine, 10 individuals developed precancerous vulvar lesions and nine developed precancerous vaginal lesions, all related to HPV types 16 or 18. No one in the Gardasil group developed either kind of precancerous lesion due to HPV types 16 or 18.

There was no evidence for benefit among women found to have been previously infected, prior to immunization, with the HPV types included in the vaccine. Therefore, to receive Gardasil’s full potential for benefit, it is important to be vaccinated prior to becoming infected with the HPV strains contained in the vaccine.

Gardasil’s label has been revised to note that presently available information is insufficient to support use beyond age 26, the current FDA-approved age. Also, new information has been added showing that Gardasil does not protect against diseases caused by HPV types not contained in the vaccine.

No vaccine is 100 percent effective, and Gardasil does not protect against HPV infections that a woman may already have at the time of vaccination. Therefore, all women should get regular Pap tests, even after they have been vaccinated. Routine Pap screening remains critically important to detect precancerous changes, which would allow treatment before cancer develops.

Since the FDA approved Gardasil in 2006, the majority of reported adverse events have not been serious. The most commonly reported adverse events have included syncope (fainting), pain at the injection site, headache, nausea, and fever. Fainting is common after injections and vaccinations, especially in adolescents. Falls after fainting may sometimes cause serious injuries, such as head injuries, which can be prevented with simple steps, such as keeping the vaccinated person seated for up to 15 minutes after vaccination. This observation period is also recommended to watch for severe allergic reactions, which can occur after any immunization.

As part of the original approval, Merck committed to a safety surveillance study of 44,000 individuals in a managed care organization. The study is assessing short- and long-term safety for all of Gardasil’s approved uses.

As with all vaccines, the FDA and the CDC continue to closely monitor Gardasil’s safety. Updated safety information on Gardasil was published on July 22 and can be found at www.fda.gov/cber/safety/gardasil071408.htm.

Product approval information for Gardasil can be found at www.fda.gov/cber/products/gardasil.htm.
Merck & Co. Inc. is located in Whitehouse Station, N.J.

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