Issue link: http://www.epageflip.net/i/340349
ByAndrewWelsh- Huggins The Associated Press SHILOH,OHIO Visitorsfrom around the world to two upcoming events in Ohio's Amish country could come away with more than they bargained for, health offi- cials fear — a case of mea- sles from the nation's larg- est outbreak in two de- cades. The outbreak, with more than 360 cases, started af- ter Amish travelers to the Philippines contracted mea- sles this year and returned home to rural Knox County, where it spread thanks to a lower rate of vaccination among the Amish and the difficulty public health au- thorities had in getting the word out to largely rural communities where phones are few and the Internet is nonexistent. Health officials believe the outbreak is slowing in Ohio thanks to vaccina- tion clinics and door-to- door visits by public health nurses. But Horse Prog- ress Days, an international showcase of horse-drawn equipment scheduled for Friday and Saturday, is ex- pected to draw more than 20,000 Amish and oth- ers from around the globe. And a large annual auction that raises money to help Amish families pay medi- cal bills for children with birth defects is scheduled for Saturday. Authorities are trying to spread education — and vaccination. "Very easily someone could come for these events, be exposed to someone who didn't know that they were sick, and travel home, and start another outbreak in another community some- where in the United States or overseas," said Dr. D.J. McFadden, health commis- sioner in Holmes County, site of Horse Progress Days and home to one of the country's largest Amish populations. The county has 54 cases of measles and one hospital- ization. Most of its Amish were already vaccinated be- fore the outbreak, McFad- den said. Symptoms of measles, which is caused by a vi- rus, include fevers, coughs, rashes and pinkeye. Before widespread vaccinations in the U.S. beginning in the 1950s, 450 to 500 people died each year, 48,000 were hospitalized and nearly a thousand people suffered brain damage or deafness. Though nearly eradicated in the United States, mea- sles remains common in many parts of Asia, the Pa- cific and Africa. The Amish eschew many conveniences of modern life. Their religion does not prevent them from seeking vaccinations, but because their children don't attend traditional public schools, vaccinations are not re- quired and therefore not routine. For Amish who aren't vaccinated, Ohio health of- ficials say, reasons include religious objections, unwill- ingness to shoulder the cost because they don't have in- surance, and not seeing the need for a disease that isn't common. Outreach efforts to de- liver vaccinations and ed- ucation have been ham- pered by communication — few Amish have phones — transportation and the strapped resources of rural counties without big health departments, said Richland County public health nurse Sue McFarren. But when they're con- tacted, most Amish have cooperated, she said. Of- ficials have distributed about 10,500 vaccines in Ohio, about half in Holmes County in central Ohio. The other affected areas are mostly, but not all, nearby — in Crawford, Ashland, Co- shocton, Highland, Holmes, Richland, Stark and Wayne counties. "They have been excel- lent about quarantining themselves," McFarren said. "If they have a case, they stay home until it's run its course." HEALTH Amish events coincide with measles outbreak TOME.PUSKAR—THEASSOCIATEDPRESS Young Mennonite girls gather at the health and safety clinic, which included a Measles, Mumps, & Rubella vaccinations in Shiloh, Ohio. Health officials said Ohio's current outbreak of measles consists of more than 360cases and is the biggest in the U.S. since 1994. THE ASSOCIATED PRESS Jon Sacker and his wife Sallie, discuss Sacker's struggle to survive until a double lung transplant. Sacker was too sick to transplant until doctors tried an experimental device that worked like dialysis for his lungs, filtering out harmful carbon dioxide and buying him time to eventually receive a lifesaving transplant. By Lauran Neergaard The Associated Press WASHINGTON Jon Sacker was near death, too sick for doctors to attempt the double lung transplant he so desperately needed. His only chance: An exper- imental machine that es- sentially works like dialy- sis for the lungs. But the device has not been approved by the Food and Drug Administration and there were none in the country. It would take an overnight race into Can- ada to retrieve a Hemo- lung. Sacker rapidly im- proved as the device cleansed his blood of car- bon dioxide — so much so that in mid-March, 20 days later, he got a trans- plant after all. "That machine is a life- saver," Sacker said from the University of Pitts- burgh Medical Center. Sacker's struggle high- lights a critical void: There is no fully functioning ar- tificial lung to buy time for someone awaiting a trans- plant, like patients who need a new heart can stay alive with an implanted heart pump or those with failing kidneys can turn to dialysis. "It seems like it should be possible for the lung as well," said Dr. Andrea Ha- rabin of the National Insti- tutes of Health. NIH-funded research- ers are working to develop wearable "respiratory as- sist devices" that could do the lungs' two jobs — supplying oxygen and get- ting rid of carbon dioxide — without tethering pa- tients to a bulky bedside machine. So when Sacker needed an emergency fix, Dr. Christian Bermudez, UPMC's chief of cardiotho- racic transplants, gambled on the unapproved Hemo- lung. "We had no other op- tions," he said. Donatedlungs Cystic fibrosis destroyed Sacker's own lungs. The Moore, Oklahoma, man received his first double lung transplant in 2012. He thrived until a severe infection last fall dam- aged his new lungs, spur- ring rejection. By Febru- ary, he needed another transplant. The odds were long. Do- nated lungs are in such short supply that only 1,923 transplants were per- formed last year, just 80 of them repeats, according to the United Network for Or- gan Sharing. Still, the Pittsburgh hos- pital, known for tackling tough cases, agreed to try — only to have Sacker, 33, arrive too debilitated for an operation. A ventilator was providing adequate oxygen. But carbon diox- ide had built to toxic lev- els in his body. "I didn't see any other alternative other than withdrawing support from this young man," Bermu- dez said. Then he remembered the Hemolung, invented by Pittsburgh engineering colleagues as an alterna- tive to ECMO. It was de- signed to treat patients with a different lung dis- ease, called COPD, during crises when their stiffened lungs retain too much car- bon dioxide, Federspiel said. The Hemolung recently was approved in Europe and Canada; its maker is planning the stricter U.S. testing required by FDA. For Sacker to become the first U.S. Hemolung pa- tient, hospital safety offi- cials would have to agree and notify FDA. "We had actually just al- most decided to turn the ventilator off, because we were putting him through suffering," Sacker's wife, Sallie, recalled. Then the phone rang: The experi- ment was on. But Pittsburgh-based ALung Technologies Inc. couldn't get a device shipped for a few days. Doctors feared Sacker wouldn't live that long. Late at night, ALung CEO Peter DeComo tracked down a device in Toronto, and started driving. It took some ex- plaining to get the un- approved medical de- vice past U.S. border of- ficials. But the next day, Sacker was hooked up, and quickly improved. Artifical lungs Federspiel, also an ALung co-founder, said re- searchers' ultimate goal is a fully functioning, porta- ble artificial lung. Varieties under develop- ment consist of small bun- dles of hollow, permeable fibers. As blood pumps over the fibers, oxygen flows outside to the blood and carbon dioxide re- turns, explained Dr. Bart- ley Griffith of the Univer- sity of Maryland. He has reported success in sheep, and hopes to begin the first human tests within three years. The idea: Small tubes would connect the fiber device, worn around the waist, to blood vessels, so that patients could move around, keeping up their muscle strength instead of being restricted to bed. There's "at the least the inkling that we can dream of sending somebody home with an artificial lung," Griffith said. Gaining strength Back in Pittsburgh, Sacker is slowly gaining strength with his second set of transplanted lungs. He doesn't remember the fight for his life; he was sedated through it. But his wife has told him how touch and go it was. "You get a call at the last second about a de- vice that has never been used here in the United States — that's a miracle," he said. Device buys time for lung transplant HEALTH At least 360 cases reported in Ohio The Associated Press WASHINGTON Iraq is in- creasingly turning to other governments like Iran, Rus- sia and Syria to help beat back a rampant insurgency because it cannot wait for additional American mili- tary aid, Baghdad's top en- voy to the U.S. said Tuesday. Such alliances test the Obama administration's in- fluence overseas and raise risks for the U.S. as some of its main global opponents consider joining forces. Moreover, a partnership that stretches from Tehran and through Baghdad into Damascus could also so- lidify a Shiite-led crescent across much of the Mideast at a time when the Sunni- led insurgency in Iraq is trying to create an Islamic state through the region. Iraqi Ambassador Luk- man Faily stopped short of describing enduring mili- tary relationships with any of the other nations that are offering to help Iraq fight the Islamic State of Iraq and the Levant. And he said Baghdad would prefer to work with the U.S. But Faily said delays in U.S. aid have forced Iraq to seek help elsewhere. He also called on the U.S. to launch targeted airstrikes as a "crucial" step against the insurgency. So far, the Obama administration has resisted airstrikes in Iraq but has not ruled them out. "Time is not on our side," Faily told an audience at the Carnegie Endowment for International Peace in Washington. "Further delay only benefits the terrorists." His comments came as chaos in Baghdad continued. Despite a constitutional deadline to name a new par- liament speaker, minority Sunni and Kurdish lawmak- ers walked out of the first session of the newly seated legislature Tuesday, dash- ing hopes for the quick for- mation of a new government that could hold the country together in the face of a mil- itant blitz. Hours later, ISIL leader Abu Bakr al-Baghdadi calledonMuslimsworldwide to join the battle and help build an Islamic state in land thattheextremist group con- trols in Iraq and Syria. Meanwhile, the United Nations said more than 2,400 people were killed in Iraq in June, making it the deadliest month in the country in years. The Obama administra- tion has been hesitant to send much military aid to Iraq for fear of dragging the U.S. into another years-long Mideast war. WASHINGTON, D.C. 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