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Washington Views
WASH I
VIEWS
The priority question that must be answered by every physician when he injects Asian influenza vaccine is: ''Am I protecting the life of a patient afflicted with heart disease, diabetes, or some other chronic ailment, for whom contraction of influenza may be of serious consequences, or am I protecting a vigorous, healthy individual because he may be temporarily prevented from administering an essential industrial or government operation?'' During periods of short supply of urgently-needed preventive medication, the physician's first objective is to preserve life, but what about our national security? This depends upon continuous functioning of our complex economy with the aid of healthy individuals more than upon the helpless young and feeble aged. The question then becomes: ''Which is more important, the individual or our country? ' ' Healthy minds and bodies trained to highest levels of performance plus the courage and rational thinking of dynamic, impartial, inspiring leaders are needed by the Western democracies more urgently than ever in the global struggle for a free world. Russia is planning world domination through mass production of scientific manpower and use of psychological warfare. Even forgetting Sputnik and the fact that the world's largest atom smasher (10-Bev) is in Russia, recent data are startling: 63,000 Russian graduates in engineering annually versus 23,000 in the U.S.; total number of scientists of equivalent stature almost equal to that in the U.S.; 73 medical schools with 140,000 students in Russia compared with 76 in this country with about 28,000 students. Overriding factors currently controlling the American scene are: expanding population, vast economic growth, mobility of personnel, rising aspirations of man everywhere, rising demand for education, and---increasing recognition of interdependence, according to speakers at the recent 2-day annual meeting of the American Council on Education held at Washington, D.C. Our population during the next 100 years will grow to 500,000,000, according to recent estimates, and this country will begin to run out of space for its citizens. Throughout the hospitals of the world, there is epidemic spread, through person-to-person contact, of antibiotic-resistant Staphylococcus aureus type 42B/52/81, which causes respiratory and skin infections, according to reports from the American College of Surgeons. In spite of our urgings to the contrary, a few drug manufacturers have begun promoting their products on the basis that they are effective in preventing Asian influenza even though the only known preventative is a vaccine. The Federal Trade Commission is taking appropriate action but not before a dark shadow has been cast over the entire profession of Pharmacy. Misleading the public through such false and dishonest promotion of drugs is vicious, reprehensible, and repugnant to all upright persons. Some of the executives involved, unfortunately, have been top-flight leaders in both Pharmacy and Medicine. VOL 18, NO. 11, NOVEMBER, 1957/ PRACTICAL PHARMACY EDITION
637
LAST MINUTE NEWS The influenza pandemic has girdled the world in a year and since it first struck the United States in June of this year has developed into an epidemic which reached every section of the nation by the beginning of October. In 112 of the largest U.S. cities, the number of deaths from influenza and pneumonia has increased 50%. The death rate from influenza in New York City rose during October to a high of about 4 a day. Both type A' and type B influenza infections have been demonstrated in some individuals, and total infections number in the millions. Although statements are being made that Asian influenza vaccine is less effective than predicted, no one can say at this time that the antibody levels produced in the blood are unsatisfactoril y low. In any event, it is better to have reasonably good protection rather than none at all. The Public Health Service has considered the possibility of using 0.1 cc. intracutaneously but after careful study still recommends the 1 cc. dose subcutaneously of flu vaccine. Asian influenza vaccine is now being released at the rate of more than 7,000,000 cc. per week. During the first 9 months of 1955, which includes the polio season, there were about 8 ,000 paralytic poliomyelitis cases. After administering the Salk vaccine for 2 years, an 80% drop in these cases was reported by Marion B. Folsom , Secretary of Health, Education, and Welfare. Only some 1,600 paralytic poliomyelitis cases were reported during the first 9 months of 1957. The disease ca.n be virtually eliminated if Americans under 40 will take the vaccine during the next year. Out of a total U.S. population of 109,000,000 persons under 40, in the highest priority group of 67,000,000 (under 20 years of age and expectant mothers) only 25,000,000 have received all3 injections, 22,000,000 have received 2 injections, 11,000,000 have received 1 injection. and 9,000,000 have received no vaccine. Of the 42,000,000 persons in the group 20 to 39 years old, 3,000,000 have been vaccinated with 3 doses, 5,000,000 with 2 doses, and 6,000,000 with 1 dose; 28,000,000 adults have had no vaccine. 80% of Medicare patients are f emale. Asian influenza vaccine will soon be double the present strength.
638
An export quota of 5,000,000 cc. of Salk Vaccine has been established for the fourth quarter of 1957. A nation-wide survey of severe reactions to antibiotics reported by Henry Welch at the Fifth Annual Symposium on Antibiotics shows an increase in the incidence of the reactions to these drugs. More than 1,000 lifethreatening reactions occur annually. More than 900 of these were due to penicillin, 72 of which resulted in death. In some patients, dramatic relief from penicillin reactions was obtained with penicillinase, according to R. M. B ecker, M.D. , who says the 200 to 300 deaths from penicillin reactions predicted for this year possibly could be obviated by the use of the enzyme intravenously. Resistance studies performed in the hospital do not indicate promiscuous use of antibiotics in the private physician's practice, according to R. S. Griffith, M .D., and his colleagues from the Lilly Research Laboratories also reporting at the antibiotic symposium. Administration of oxytetracycline and tetracycline to patients in the Philippine General Hospital suffering with influenza decreased the length of illness and the incidence of bronchiopneumonia, according to Angel Florentin of PGH. The Public Health Service now recommends that BCG tuberculosis vaccine be used only in groups where exposure to the disease is unusually high and where other means of control are inadequate. At the present attack rate, of the 55,000,000 persons in the U.S. injected with the tuberculosis bacillus, 2,750,000 will have the disease in an active form during their lifetime. Some 80,000 cases costing $725,000,000 are reported annually . BCG vaccine is ineffective in persons already infected. Factors influencing your chances of being a heart disease victim are part! y hereditary, but your weight, blood cholesterol level, blood pressure, and amount of cigarette smoking are important, according to Drs. Paul D . White, Samuel A. Levine, Frederick J. Stare, and Howard B. Sprague. New findings make it medically unjustifiable to recommend therapeutic abortions for women who contract German measles early in pregnancy. Children born to these women will be normal about 9 times out of 10, according to physicians of New York City and New York State Departments of Health.
JOURNAL OF THE AMERICAN PHARMACEUTICAL ASSOCIATION
On all school levels in this country, we now have a fourth of the nation in school, according to John A. Perkins, Under Secretary of Health, Education, and Welfare. Some 142,000 persons, about 7% of all Federal employees, are engaged in research and development activities. According to Aims C. McGuinness, M.D., of HEW, the U.S. will spend about $330,000,000 for medical research this year, more than half of which comes from the Federal Government. The $222,000,000 appropriated by the U.S. Government for medical research for the current fiscal year is far more than the combined total for the ethical drug industry, philanthropic institutions, universities, and colleges. Some 300,000 persons are now sheltered in 25,000 nursing homes across the nation at a cost of $550,000,000 per year. It would be interesting to know how the drugs, particularly those which should be distributed only on prescription, are being handled in these institutions. For fiscal year 1957, a total of 71,570 persons were rehabilitated through the State- Federal vocational rehabilitation program, a new record. Some 71,000 rehabilitated men and women will add 109,000,000 man-hours to the nation's production potential, and increase their earnings nearly $120,000,000. Meprobamate accounted for about $24,700,000 of the $41,835,609 total sales of Carter Products, Inc., which also manufactures Little Liver Pills, Arrid deodorant, Nair depilatory, and Rise pressurized shaving cream. The annual accidental death toll in the U.S. has remained fairly constant at about 100,000 since 1932. In addition, some 9,500 injuries last year caused financial losses of over $11,200,000,000. Dr. Daniel Bovet was awarded the 1957 Nobel Prize for Medicine for his work in antihistamines. More than $100,000,000 is now spent annually in administering the four public welfare programs for the aged, the blind, the totally and permanently disabled, and dependent children. Total expenditure, shared by the Federal and State Governments, on a matching funds arrangement is now $1,700,000,000. A trend is evident in the Sun Ray Drug Company's plans to add 45 new drug supermarkets to its 160 drug stores during the next 15 months.
VIEWS
The priority question that must be answered by every physician when he injects Asian influenza vaccine is: ''Am I protecting the life of a patient afflicted with heart disease, diabetes, or some other chronic ailment, for whom contraction of influenza may be of serious consequences, or am I protecting a vigorous, healthy individual because he may be temporarily prevented from administering an essential industrial or government operation?'' During periods of short supply of urgently-needed preventive medication, the physician's first objective is to preserve life, but what about our national security? This depends upon continuous functioning of our complex economy with the aid of healthy individuals more than upon the helpless young and feeble aged. The question then becomes: ''Which is more important, the individual or our country? ' ' Healthy minds and bodies trained to highest levels of performance plus the courage and rational thinking of dynamic, impartial, inspiring leaders are needed by the Western democracies more urgently than ever in the global struggle for a free world. Russia is planning world domination through mass production of scientific manpower and use of psychological warfare. Even forgetting Sputnik and the fact that the world's largest atom smasher (10-Bev) is in Russia, recent data are startling: 63,000 Russian graduates in engineering annually versus 23,000 in the U.S.; total number of scientists of equivalent stature almost equal to that in the U.S.; 73 medical schools with 140,000 students in Russia compared with 76 in this country with about 28,000 students. Overriding factors currently controlling the American scene are: expanding population, vast economic growth, mobility of personnel, rising aspirations of man everywhere, rising demand for education, and---increasing recognition of interdependence, according to speakers at the recent 2-day annual meeting of the American Council on Education held at Washington, D.C. Our population during the next 100 years will grow to 500,000,000, according to recent estimates, and this country will begin to run out of space for its citizens. Throughout the hospitals of the world, there is epidemic spread, through person-to-person contact, of antibiotic-resistant Staphylococcus aureus type 42B/52/81, which causes respiratory and skin infections, according to reports from the American College of Surgeons. In spite of our urgings to the contrary, a few drug manufacturers have begun promoting their products on the basis that they are effective in preventing Asian influenza even though the only known preventative is a vaccine. The Federal Trade Commission is taking appropriate action but not before a dark shadow has been cast over the entire profession of Pharmacy. Misleading the public through such false and dishonest promotion of drugs is vicious, reprehensible, and repugnant to all upright persons. Some of the executives involved, unfortunately, have been top-flight leaders in both Pharmacy and Medicine. VOL 18, NO. 11, NOVEMBER, 1957/ PRACTICAL PHARMACY EDITION
637
LAST MINUTE NEWS The influenza pandemic has girdled the world in a year and since it first struck the United States in June of this year has developed into an epidemic which reached every section of the nation by the beginning of October. In 112 of the largest U.S. cities, the number of deaths from influenza and pneumonia has increased 50%. The death rate from influenza in New York City rose during October to a high of about 4 a day. Both type A' and type B influenza infections have been demonstrated in some individuals, and total infections number in the millions. Although statements are being made that Asian influenza vaccine is less effective than predicted, no one can say at this time that the antibody levels produced in the blood are unsatisfactoril y low. In any event, it is better to have reasonably good protection rather than none at all. The Public Health Service has considered the possibility of using 0.1 cc. intracutaneously but after careful study still recommends the 1 cc. dose subcutaneously of flu vaccine. Asian influenza vaccine is now being released at the rate of more than 7,000,000 cc. per week. During the first 9 months of 1955, which includes the polio season, there were about 8 ,000 paralytic poliomyelitis cases. After administering the Salk vaccine for 2 years, an 80% drop in these cases was reported by Marion B. Folsom , Secretary of Health, Education, and Welfare. Only some 1,600 paralytic poliomyelitis cases were reported during the first 9 months of 1957. The disease ca.n be virtually eliminated if Americans under 40 will take the vaccine during the next year. Out of a total U.S. population of 109,000,000 persons under 40, in the highest priority group of 67,000,000 (under 20 years of age and expectant mothers) only 25,000,000 have received all3 injections, 22,000,000 have received 2 injections, 11,000,000 have received 1 injection. and 9,000,000 have received no vaccine. Of the 42,000,000 persons in the group 20 to 39 years old, 3,000,000 have been vaccinated with 3 doses, 5,000,000 with 2 doses, and 6,000,000 with 1 dose; 28,000,000 adults have had no vaccine. 80% of Medicare patients are f emale. Asian influenza vaccine will soon be double the present strength.
638
An export quota of 5,000,000 cc. of Salk Vaccine has been established for the fourth quarter of 1957. A nation-wide survey of severe reactions to antibiotics reported by Henry Welch at the Fifth Annual Symposium on Antibiotics shows an increase in the incidence of the reactions to these drugs. More than 1,000 lifethreatening reactions occur annually. More than 900 of these were due to penicillin, 72 of which resulted in death. In some patients, dramatic relief from penicillin reactions was obtained with penicillinase, according to R. M. B ecker, M.D. , who says the 200 to 300 deaths from penicillin reactions predicted for this year possibly could be obviated by the use of the enzyme intravenously. Resistance studies performed in the hospital do not indicate promiscuous use of antibiotics in the private physician's practice, according to R. S. Griffith, M .D., and his colleagues from the Lilly Research Laboratories also reporting at the antibiotic symposium. Administration of oxytetracycline and tetracycline to patients in the Philippine General Hospital suffering with influenza decreased the length of illness and the incidence of bronchiopneumonia, according to Angel Florentin of PGH. The Public Health Service now recommends that BCG tuberculosis vaccine be used only in groups where exposure to the disease is unusually high and where other means of control are inadequate. At the present attack rate, of the 55,000,000 persons in the U.S. injected with the tuberculosis bacillus, 2,750,000 will have the disease in an active form during their lifetime. Some 80,000 cases costing $725,000,000 are reported annually . BCG vaccine is ineffective in persons already infected. Factors influencing your chances of being a heart disease victim are part! y hereditary, but your weight, blood cholesterol level, blood pressure, and amount of cigarette smoking are important, according to Drs. Paul D . White, Samuel A. Levine, Frederick J. Stare, and Howard B. Sprague. New findings make it medically unjustifiable to recommend therapeutic abortions for women who contract German measles early in pregnancy. Children born to these women will be normal about 9 times out of 10, according to physicians of New York City and New York State Departments of Health.
JOURNAL OF THE AMERICAN PHARMACEUTICAL ASSOCIATION
On all school levels in this country, we now have a fourth of the nation in school, according to John A. Perkins, Under Secretary of Health, Education, and Welfare. Some 142,000 persons, about 7% of all Federal employees, are engaged in research and development activities. According to Aims C. McGuinness, M.D., of HEW, the U.S. will spend about $330,000,000 for medical research this year, more than half of which comes from the Federal Government. The $222,000,000 appropriated by the U.S. Government for medical research for the current fiscal year is far more than the combined total for the ethical drug industry, philanthropic institutions, universities, and colleges. Some 300,000 persons are now sheltered in 25,000 nursing homes across the nation at a cost of $550,000,000 per year. It would be interesting to know how the drugs, particularly those which should be distributed only on prescription, are being handled in these institutions. For fiscal year 1957, a total of 71,570 persons were rehabilitated through the State- Federal vocational rehabilitation program, a new record. Some 71,000 rehabilitated men and women will add 109,000,000 man-hours to the nation's production potential, and increase their earnings nearly $120,000,000. Meprobamate accounted for about $24,700,000 of the $41,835,609 total sales of Carter Products, Inc., which also manufactures Little Liver Pills, Arrid deodorant, Nair depilatory, and Rise pressurized shaving cream. The annual accidental death toll in the U.S. has remained fairly constant at about 100,000 since 1932. In addition, some 9,500 injuries last year caused financial losses of over $11,200,000,000. Dr. Daniel Bovet was awarded the 1957 Nobel Prize for Medicine for his work in antihistamines. More than $100,000,000 is now spent annually in administering the four public welfare programs for the aged, the blind, the totally and permanently disabled, and dependent children. Total expenditure, shared by the Federal and State Governments, on a matching funds arrangement is now $1,700,000,000. A trend is evident in the Sun Ray Drug Company's plans to add 45 new drug supermarkets to its 160 drug stores during the next 15 months.