FDA reports more cases of salmonella illnesses

WASHINGTON - The government on Saturday increased the number of people reported being sickened in a record salmonella outbreak in which tomatoes are the leading suspect although investigators are testing other types of fresh produce.

There have been 943 reported cases nationwide, with at least 130 hospitalizations since mid-April after the first salmonella illnesses appeared, the Food and Drug Administration said Saturday. That compares with a total of 922 people about two days ago and 869 reported earlier in the past week.

The FDA also said it had begun looking at jalapeno peppers as a possible cause of the outbreak, as well as ingredients used to make salsa such as cilantro and Serrano peppers. Tomatoes continue to be investigated as well, spokeswoman Stephanie Kwisnek said.

On Tuesday, the government said it would test numerous other kinds of fresh produce commonly served with fresh tomatoes while insisting that tomatoes remained the leading culprit.

Investigators with the Centers for Disease Control and Prevention have interviewed people sickened in June to find out what they ate and to compare their diets with those of healthy relatives and neighbors. Officials so far have not revealed early findings, except to say they supported the investigation's new move.

Among the possibilities FDA has said it was exploring is whether tomatoes and other produce are sharing a common packing or shipping site where both might become contaminated, or whether multiple foods might be tainted while being grown on adjoining farms or with common water sources.

Officials have said some patients have told the Centers for Disease Control and Prevention they ate raw tomatoes in fresh salsa and guacamole.

CDC spokesman Glen Nowak said Saturday that the agency's scientists are working around the clock to try to pinpoint the source of the outbreak but are not ready to single out anything. Salsa ingredients, including peppers, are among the items being tested, Nowak said. "We don't rank the items we're looking at."

Scientists: Watermelon yields Viagra-like effects

LUBBOCK, Texas - A slice of cool, fresh watermelon is a juicy way to top off a Fourth of July cookout and one that researchers say has effects similar to Viagra — but don't necessarily expect it to keep the fireworks going all night long.

Watermelons contain an ingredient called citrulline that can trigger production of a compound that helps relax the body's blood vessels, similar to what happens when a man takes Viagra, said scientists in Texas, one of the nation's top producers of the seedless variety.

Found in the flesh and rind of watermelons, citrulline reacts with the body's enzymes when consumed in large quantities and is changed into arginine, an amino acid that benefits the heart and the circulatory and immune systems.

"Arginine boosts nitric oxide, which relaxes blood vessels, the same basic effect that Viagra has, to treat erectile dysfunction and maybe even prevent it," said Bhimu Patil, a researcher and director of Texas A&M's Fruit and Vegetable Improvement Center. "Watermelon may not be as organ-specific as Viagra, but it's a great way to relax blood vessels without any drug side effects."

Todd Wehner, who studies watermelon breeding at North Carolina State University, said anyone taking Viagra shouldn't expect the same result from watermelon.

"It sounds like it would be an effect that would be interesting but not a substitute for any medical treatment," Wehner said.

The nitric oxide can also help with angina, high blood pressure and other cardiovascular problems, according to the study, which was paid for by the U.S. Department of Agriculture.

More citrulline — about 60 percent — is found in watermelon rind than in the flesh, Patil said, but that can vary. But scientists may be able to find ways to boost the concentrations in the flesh, he said.

Citrulline is found in all colors of watermelon and is highest in the yellow-fleshed types, said Penelope Perkins-Veazie, a USDA researcher in Lane, Okla.

She said Patil's research is valid, but with a caveat: One would need to eat about six cups of watermelon to get enough citrulline to boost the body's arginine level.

"The problem you have when you eat a lot of watermelon is you tend to run to the bathroom more," Perkins-Veazie said.

Watermelon is a diuretic and was a homeopathic treatment for kidney patients before dialysis became widespread.

Another issue is the amount of sugar that much watermelon would spill into the bloodstream — a jolt that could cause cramping, Perkins-Veazie said.

Patil said he would like to do future studies on how to reduce the sugar content in watermelon.

The relationship between citrulline and arginine might also prove helpful to those who are obese or suffer from type-2 diabetes. The beneficial effects — among them the ability to relax blood vessels, much like Viagra does — are beginning to be revealed in research.

Citrulline is present in other curcubits, like cucumbers and cantaloupe, at very low levels, and in the milk protein casein. The highest concentrations of citrulline are found in walnut seedlings, Perkins-Veazie said.

"But they're bitter and most people don't want to eat them," she said.

Haywire brain chemical linked to sudden baby death

WASHINGTON - Scientists have new evidence that the brain chemical best known for regulating mood also plays a role in the mystifying killer of seemingly healthy babies — sudden infant death syndrome

Autopsied brain tissue from SIDS babies first raised suspicion that an imbalance in serotonin might be behind what once was called crib death.

But specialists couldn't figure out how that defect could kill. Now researchers in Italy have engineered mice born with serotonin that goes haywire — and found the brain abnormality is enough to spur sudden death, in ways that mesh with other clues from human babies.

Moreover, the work suggests it might one day be possible to test newborns for their risk of SIDS.

For now, even an animal experiment can offer a message for devastated families:

"It should provide them with some sense of comfort that there was nothing they could have done to prevent it," said Dr. Marian Willinger, a SIDS specialist at the National Institute of Child Health and Human Development, who wasn't part of the study. "It is a real disease."

The work was published in Friday's edition of the journal Science.

SIDS is the sudden death of an otherwise healthy infant — anywhere between ages 1 month and 1 year — that can't be attributed to any other cause. It kills more than 2,000 U.S. infants each year, and is the leading killer of babies after the newborn period.

Babies should always be placed to sleep on their backs, as the risk of SIDS increases greatly when babies sleep on their stomachs. And parents are urged not to allow anyone to smoke around their babies, or to let their babies get too warm while sleeping.

But beyond those risk factors, doctors have little advice.

In 2006, Dr. Hannah Kinney of Children's Hospital Boston compared brain tissue from 31 SIDS babies and 10 infants who died of other causes. The SIDS babies had abnormalities in their brain stem that led to imbalances in serotonin, a neurotransmitter or chemical that helps brain cells communicate.

Low serotonin famously plays a role in depression. Less known to laymen is that it also helps regulate some of the body's most basic functions — breathing, heart rate, body temperature, arousal from sleep.

Dr. Cornelius Gross and colleagues at the European Molecular Biology Laboratory in Italy were studying how the serotonin system turns itself on and off when they stumbled onto the SIDS connection.

They genetically engineered mice to have an overactive serotonin-regulating receptor, which in turn reduced the amount of serotonin in the brains of otherwise normal baby mice.

More than half of the mice abruptly died before they were 3 months old. More intriguing, they had erratic episodes where their heart rate would drop and, five to 10 minutes later, so would their body temperature, Gross reported. Sometimes they died in the midst of what Gross calls those crises, other times afterward.

The exact cellular defects in the mice and the human babies studied so far aren't identical, researchers caution.

But heart and temperature problems are consistent with what little human data is available, Willinger noted.

Here's another key: Gross could switch on and off the genetic defect that controlled serotonin levels in the mice. By doing so, he showed that older baby animals were less likely to die from haywire serotonin than younger ones.

"This is a very exciting part of the research," says Willinger — because doctors have long suspected that if at-risk babies just get through a developmental period, they'll be OK. That's impossible to test in humans, however

Salmonella probe adds foods served with tomatoes

WASHINGTON - Adding to tomato confusion, the government is about to start testing numerous other types of fresh produce in the hunt for the source of the nation's record salmonella outbreak — even as it insists tomatoes remain the leading suspect.

Investigators are mum on exactly what other vegetables are getting tracked.

Items commonly served with fresh tomatoes is the only hint Food and Drug Administration food safety chief Dr. David Acheson would give, calling it "irresponsible" to point a finger until he has more evidence that some other food really deserves the extra scrutiny.

"Tomatoes aren't off the hook," he stressed. "It's just that there is clearly a need to think beyond tomatoes."

Still, Acheson widened FDA's probe on Tuesday, activating an emergency network of food laboratories around the country in anticipation of lots of additional samples to test.

The reason is that the outbreak continues, with 869 people now confirmed having taken ill. Most troublesome, at least 179 of them fell ill in June, the latest on June 20. That is more than two months after the first salmonella illnesses appeared, meaning the outbreak is continuing weeks longer than food-poisoning specialists had expected — and suggesting the culprit is still on the market.

Over the weekend, disease detectives with the Centers for Disease Control and Prevention began interviewing people sickened in June to find out what they ate and to compare their diets with those of healthy relatives and neighbors. Officials wouldn't reveal early findings, except to say they supported the investigation's new move.

Among the possibilities FDA is exploring is whether tomatoes and other produce are sharing a common packing or shipping site where both might become contaminated, or whether multiple foods might be tainted while being grown on adjoining farms or with common water sources.

Pressure is increasing on the FDA to solve the case, with the tomato industry suffering millions of dollars in losses and pushing for Congress to investigate how the agency handled the outbreak.

But Acheson said Tuesday that there's a growing misconception in the public that if tomatoes really were to blame, the outbreak would only have lasted six weeks.

That's just not true, he said, pointing to farms that rotate harvests so as to keep producing tomatoes for months.

Tomatoes first became a suspect because of what are called "case-control" studies rapidly conducted in New Mexico and Texas, the outbreak's center, CDC food-poisoning specialist Dr. Robert Tauxe said.

Those kinds of studies compare the sick to people who are otherwise similar — in income, lifestyle, where they live — but healthy. In those initial studies, about 80 percent of the ill reported eating certain types of fresh tomatoes, far more than the healthy group did, Tauxe said. Statistically, the association was too strong to think it a coincidence.

Some food-poisoning experts say the CDC missed a key step in not taking those studies a step further and trying to trace why some of the healthy ate tomatoes without harm.

For now, the FDA continues to urge consumers nationwide to avoid raw red plum, red Roma or red round tomatoes unless they were grown in specific states or countries that the agency has cleared of suspicion. Check the FDA's Web site — http://www.fda.gov — for an updated list. Also safe are grape tomatoes, cherry tomatoes and tomatoes sold with the vine still attached.

That advice is coming under fire too because tomatoes are sent through multiple repacking and distribution sites around the country, even to Mexico and back, regardless of where they're grown. But Acheson said the advice would be fine-tuned only if new science emerges.

Even Health and Human Services Secretary Michael Leavitt expressed frustration Tuesday that the case isn't solved.

"Nothing happens fast enough when you have a problem like this," Leavitt said as he asked Congress for more funds and stronger legal powers for food and consumer safety agencies. Still, "I feel confident we will find the solution to this problem."

"Good" cholesterol may protect memory, study finds

WASHINGTON (Reuters) - Middle-aged people with low levels of so-called good cholesterol may be at higher risk for memory decline that could foreshadow Alzheimer's disease or other forms of dementia, European researchers said on Monday.

The study, involving about 3,700 British men and women, found that falling levels of high-density lipoprotein, or HDL, cholesterol were linked to declining memory by age 60. Such memory declines often precede the development of dementia such as Alzheimer's in the elderly.

Experts predict increasing numbers of people worldwide will develop Alzheimer's in the coming decades as populations in many countries grow older. Scientists are trying to identify risk factors that may appear years before the onset of dementia to help find ways to prevent or postpone it.

"Considering the way the population is aging -- the 65-plus age group being the fastest-growing age group -- we are facing a dementia time bomb," said Archana Singh-Manoux of the French National Institute for Health and Medical Research and the University College London, who led the study.

Singh-Manoux said she hoped the findings will focus attention on the possible role of higher levels of HDL cholesterol in protecting against memory loss.

The researchers looked at blood cholesterol readings and the results of a simple memory test collected when the people in the study were on average 55 years old and then again when they were on average 60.

WORD QUIZ

In the memory test, the participants had 20 words read to them, and then were asked to write down in 2 minutes all the words they could remember.

At age 55, those with low HDL cholesterol had a 27-percent higher risk of memory loss when compared to those with high HDL. At age 60, those with low HDL had a 53-percent higher risk of memory loss compared to those with high HDL levels.

The study did not track whether or not the people went on to develop dementia.

Low HDL was defined as less than 40 milligrams per deciliter (mg/dL) and high HDL was defined as at least 60 mg/dL in the study, published in the American Heart Association's journal Arteriosclerosis, Thrombosis and Vascular Biology.

Cholesterol is a fatty substance made naturally by the body and also found in many foods. High HDL levels can cut heart attack risk.

As opposed to low-density lipoprotein (LDL) cholesterol that can build up in artery walls, making them hard and narrow, HDL cholesterol takes excess cholesterol back to the liver.

LDL cholesterol is dubbed the "bad" cholesterol.

In the study, total levels of cholesterol and triglycerides

-- another type of fat found in the blood -- had no association with memory decline.

Singh-Manoux said the study did not look at the reasons that HDL cholesterol may protect memory. She said one possible explanation is that it wards off formation of beta-amyloid plaques in the brain that are a hallmark of Alzheimer's.

Previous studies have identified other early risk factors for Alzheimer's disease. In March, U.S. researchers found that having a big belly in middle age appears to greatly increase one's risk of developing Alzheimer's or another form of dementia decades later.

Mental Test Spots Alzheimer's Risk

TUESDAY, July 1 (HealthDay News)

A new questionnaire may help in both diagnosing older adults facing dementia and also in identifying individuals who need help with daily living.

The Everyday Cognition instrument consists of 39 questions to be answered by people who know the patient well.

"There have been a number of studies that show that people with mild cognitive impairment who have functional problems in addition to performing poorly on neuropsychological testing are more likely to progress in the near future," said study author Sarah Tomaszewski Farias, an assistant professor of neurology at the University of California, Davis, Medical Center in Sacramento. "One of our hopes is that this instrument will be able to help identify very early on those people at increased risk for developing Alzheimer's disease."
That would help both patients and family members prepare for what lies ahead and identify patients who need to be more closely monitored.

In addition, Farias said, the test would also help identify "people who are having [functional] problems so that we know who needs help and who doesn't."

"What's nice about this is that it is designed to pick up very early memory problems, and it's an entirely caregiver-based survey," said Dr. Scott Turner, incoming director of the Memory Disorders Program at Georgetown University Medical Center, in Washington, D.C. "This is something the caregiver can fill out, while the practitioner is looking at the patient. It could be used for screening, for diagnosis and for drug development, if you want to look for some proof that your drug is having some effect, so it has a lot of potential uses."

"They want something that they could use to ask a family member about the potential patient's everyday functioning to see if that's sensitive to picking up the likelihood of dementia early on," added Dr. Gary J. Kennedy, director of geriatric psychiatry at Montefiore Medical Center in New York City.

The findings were published in the July issue of Neuropsychology.

Existing neuropsychological tests tend to be very abstract. For the last 40 years, these tests have looked at two categories: so-called "basic" activities (such as grooming, feeding, dressing), which are affected in later stages of dementia, and "instrumental" activities of daily living (such as managing medication, finances, cooking, driving).

"I was interested in understanding how our neuropsychology tests translated into everyday problems, how our cognitive tests . . . translate into everyday problems that a person is experiencing and that a caregiver is concerned about," Farias explained.

Farias and her colleagues divided everyday functioning into seven cognitive "domains:" memory, language, semantic or factual knowledge, visual and spatial abilities, planning, organization and divided attention.

An original list of 138 items was eventually culled to 39, which was then tested in 576 older adults: 174 of whom were cognitively normal, 126 who had mild cognitive impairment (MCI), and 276 who had been diagnosed with dementia.

"Informants" (people who had known the patient for an average of almost 45 years) provided details on whether the patient could remember shopping items without a list, reading a map, balancing the checkbook, and cooking or working and talking at the same time.

Not only did the instrument confirm established diagnoses, it was also able to distinguish people with MCI from those with full-blown dementia, meaning it was able to pick up on subtle differences in function.

The results also weren't highly influenced by occupation and education levels, as are existing tests.

"This is really the first step in development the instrument," Farias said. "What we're really interested in doing is to track people over time to get a better understanding of the early signs of functional impairment."

More information

Visit the Alzheimer's Association for more on this condition.