The Top 10 Health Stories of 2006

Obesity extended beyond the borders of American abundance to nations once associated with hunger. Human-to human transmission of bird flu was confirmed among the members of an Indonesian family. Outbreaks of E.coli and salmonella in the United States raised questions about the safety of the food supply.

In 2006, many of the major health news stories were concerned with far-reaching public health threats, issues and policies, with many being international in scope. However, 2006 also delivered some very good health news, with dramatic breakthroughs and discoveries being reported in the understanding and treatment of disease, the development of vaccines and progress in stem cell research.

In conjunction with content partner Web MD, has compiled the following list of the top 10 health stories of 2006.

10. Super Bugs

Drug resistant bacteria. These staph infections have posed a huge problem within hospitals for some time, but the frightening news this year were reports that the infections had spread outside hospitals.

Known as MRSA--methicillin-resistant Staphylococcus aureus--this germ cannot be killed by an important antibiotic that usually kills staph germs. Traditional antibiotics do not work on MRSA either, and it is now the most common skin infection seen in urban hospitals. The infections are popping up all over, with the CDC reporting that MRSA infections are arising from tattoos.

Because this MRSA is being contracted outside of hospitals, researchers call the infection community-acquired MRSA. The good news is that there are still antibiotics that work against it, and that in many cases, the infection can be cured by patients simply having their boils or bscesses opened and drained by a doctor.

However, the bad news is that many MRSA infections are tough to treat, and some scientists fear MRSA infections will get nastier. This bad bug may evolve into a very bad bug, and has one so already. In rare cases, MRSA can be a flesh-eating infection.

While scientists are working on an MRSA vaccine, such a treatment remains years away.

Drug Resistant Staph Bacteria a Global Problem

9. Globesity

The battle of the bulge burst through U.S. borders to stake out new fronts in places as disparate as Africa, Asia and parts of Europe. Sixty million Chinese are believed to be obese, with much of the blame being placed on the "Americanization" of the world's diet.

Globesity: 60 Million Chinese Are Obese

In the United States, where obesity continues to be a major public health concern among children as well as adults, the food fight in 2006 was a war on trans fats, with several local governments enacting bans against the use of trans fats in restuarant cooking, and many restaurant chains removing transfats from their recipes.

New York City banned trans fats in December, capping a bad year for trans fats that began on Jan. 1, when the FDA required all foods to list trans fat content on labels. The fats must be gone from New York City restaurant fryers by July 2007 and from all restaurant food by July 2008. At that time, New York will join Tiburon, Calif., as the second trans-fat-free city in the United States.

Many foods contain trans fats. Some former culprits -- such as Oreo cookies -- are now trans-fat free.

Fast-food restaurants had been particularly quick to adopt trans fats. But many major fast-food chains are removing trans fats from their recipes. Prominent examples:

--Longhorn Steakhouses uses trans-fat-free frying oil.

--Arby's Restaurant Group says it has stopped serving french fries with trans fat. By May 2007, the restaurant says that three-fourths of its menu will be trans-fat free.

--Taco Bell is switching to trans-fat-free frying oil, the company announced in November. It expects to complete the change by April 2007.

--KFC will use trans-fat-free cooking, the company announced in October. It expects to complete the change by the end of April 2007. Biscuits will be the only KFC menu item that will continue to contain trans fats. Yum! Foods owns both KFC and Taco Bell.

--Chili's says it's now using trans-fat-free frying oil.

--Uno's says it has only two dishes that still contain trans fats -- scampi and a peanut-butter-cup dessert.

--McDonald's said in 2002 it would change to a low-trans-fat cooking oil. That didn't happen, so a group called sued them. In settling the suit, McDonalds agreed to pay $7 million to the American Heart Association for trans-fat-reduction programs. Meanwhile, McDonald's has cut trans fats from its chicken items, lists the trans-fat content of all menu items both on its web site and in its stores, and says it's still working on a way to reduce trans fats in other menu items.

--Wendy's restaurants have switched to trans-fat-free cooking oil for their french fries and breaded chicken items. Some of these food items sent to the chain's restaurants are prefried in oil containing trans fats. Wendy's says it's working to eliminate trans fat from all its menu items.

Eliminating trans fats will not make fatty foods good for you. Many food items -- particularly fried foods -- contain unhealthy levels of saturated fats.

New York City Restaurants Prepare for Trans Fats Ban

8. Food Safety Scare

While the proverbial food police were expelling trans fats from American diets, a different kind of food-related health threat emerged from the very foods people are encouraged to eat for good health--fresh produce.

A deadly, nation-wide outbreak of E.coli bacteria in spinach throughout November saw the popular, nutrient-packed leafy green disappear from supermarket shelves and restaurant menus, with many, if not most people, extremely reluctant to return to eating spinach at year's end.

The spinach scare was followed quickly by botulism contamination in carrot juice, and a second E.coli outbreak in Taco Bell restaurants in the Northeast. After first reporting they had traced the outbreak to onions and scallions, investigators named lettuce as the Taco Bell culprit. As of this writing, however, questions remain about the source of the Taco Bell outbreak.

While consumer fears about the safety of fresh produce may further exacerbate the nutritional concerns of an American diet already deficient in fresh fruits and vegetables, the produce scares raised serious questions about the integrity of the U.S. food safety system.

Some public health advocates say the outbreaks underscore problems at the FDA. Indeed, a May 2006 Harris poll found that 70 percent of Americans have a negative opinion of the agency.

There are some things you can do to protect yourself from food poisoning. These include keeping foods refrigerated, looking for signs of deterioration in bagged produce, buying foods with the latest possible "sell-by" date, and tossing out foods that are no longer fresh.

Bagged Spinach E. Coli Outbreak Spreads to 19 States

Taco Bell Sales Hurt By E. Coli Outbreak

7. Over the Counter Morning-After Pill

The FDA approved over-the-counter sales of the morning after pill--the name brand is Plan B---making it much easier for women to have access to the drug that can prevent pregnancy if taken within 72 hours of unprotected sex.

Prior to the approval of over-the-counter-sales, emergency contraception was available only through a doctor's prescription--which could cause problems considering that the pills are only effective within a very brief and immediate window following a birth control failure.

The morning-after pill is often confused with the abortion pill, RU-486, but the medications are actually very different.

Plan B prevents pregnancy, but cannot cause an abortion. When taken within 72 hours of unprotected intercourse, Plan B prevents pregnancy about 99 percent of the time. Plan B is even more effective when taken within 24 hours of intercourse.

However, if taken too late, women who become pregnant after taking Plan B have normal pregnancies.

The approval has some strings attached. Only stores staffed by a health professional can sell Plan B without a prescription. And women under age 18 still need a doctor's prescription.

FDA Approves Nonprescription Sale of Morning-After Pill

6. Inhaled Insulin for Diabetics

For people with diabetes, 2006 marks the beginning of a new era: no-shot insulin.

Previously, people who needed insulin had to take the life-saving hormone by injection. In January, the FDA approved an inhalable insulin product called Exubera.

Market analysts predicted it would be a blockbuster. It yet may be. But patient and doctor uptake has been slow.

Some doctors are worried about the long-term safety of inhaled insulin -- especially its effects on lung function. They suggest that it should be reserved for patients who cannot or will not use needles.

These questions will, eventually, be resolved. Meanwhile, Exubera marks the start of an era of new options for people with diabetes.

Long-Term Safety of Inhaled Insulin Needs More Study

5. Flu Fears

With public health experts predicting that a global influenza pandemic is all but inevitable, the biggest health story of 2005 carried over into 2006. These fears were inflamed earlier in the year with the confirmation that a family in a remote area of Indonesia had given bird flu to each other--the human-to-human transmission that public health officials were dreading.

While human deaths from bird flu continued to be reported in Indonesia throughout 2006, there were no additional cases of human-to-human transmission or evidence that the virus had mutated. Additionally, the infection rate of poultry seemed to have slowed.

But experts warn that the H5N1 virus being seen in Asia may not be the flu that triggers the pandemic, and on the domestic front, problems with influenza vaccine production and distribution persisted. Fortunately, as 2006 came to a close and the U.S. headed into winter, the flu season appears to have gotten off to a very slow start.

Bird Flu Kills Two Siblings in Second Family Cluster in Indonesia

4. Shingles Vaccine Cuts Agony of Aging

Until this year, a person who lived to be 85 had a 50-50 chance of getting shingles--an extremely painful condition that afflicts older people. Shingles is caused by the reactivation of the same virus that causes chickenpox; one in five people who have had chickenpox will get shingles.

Unlike chickenpox, which goes away, the virus does not. It's a herpes virus that hides out at the base of the nerves, waiting for the immune system to weaken with age or immune-suppressing drugs. When this happens, a person gets painful skin blisters -- or worse.

A third of shingles cases become the excruciating condition called postherpetic neuralgia or PHN. When shingles affects the eye, it's called ophthalmic zoster. Ophthalmic zoster may cause blindness as well as unrelenting pain.

This year, the FDA approved a shingles vaccine. The CDC now recommends routine shingles vaccination for everyone age 60 and older.

In shingles vaccine clinical trials, vaccination prevented shingles in more than half of recipients. And those who did get shingles got far milder cases. Perhaps most importantly, the shingles vaccine cuts PHN by two-thirds.

Gov't Panel Recommends Shingles Vaccine

3. Angioplasty, Stents, Cardiac Care

In November, new research overturned one of the most fundamental beliefs among doctors treating heart attacks: that opening a blocked artery through balloon angioplasty is always a good idea, even days or weeks after the attack.

The study revealed that performing the procedure too late may not help, and may even be harmful. People who had balloon angioplasty to open an artery three to 28 days after their heart attacks fared no better than those given standard medicines to prevent a second attack.

The results don't apply to patients undergoing the procedure immediately following a heart attack or most Americans suffering a heart attack. However, it does suggest that 100,000 of them every year might be able to skip the expense and risk of angioplasty and take medications instead, doctors said.

Study: Angioplasty May Not Be Best Treatment for Blocked Arteries

In a related story, the safety of another procedure used to open blocked arteries was also called into question--drug coated stents.

Drug-coated stents are the latest thing in the evolving treatment of blocked arteries. But the stent story shows that solving one problem creates another.

Doctors treating blocked arteries once had to perform bypass surgery to replace the blocked vessel. Balloon angioplasty greatly improved the options for treating blocked arteries. Using a catheter threaded into the artery, doctors inflate a balloon that opens up the blockage. Because the balloons could collapse, doctors then began using stents--wire mesh tubes--to prop open the artery.

Bare-metal stents, however, could sometimes get blocked by scar tissue. This led to the invention of stents coated with drugs that keeps the scar tissue from forming.

Prior to 2006, there seemed no end to the popularity of drug-coated stents. Patients even demanded that their cardiologists use them to prop open their clogged arteries. Now, as 2006 draws to a close, an FDA advisory panel warns that drug-coated stents carry their own risk of fatal heart attack.

To work properly, a lining of new blood-vessel cells have to heal over the inside of the stent. Drug-coated stents delay this process. Blood clots can form on the unhealed surface of the stent. This means that in rare cases, drug-eluting stents cause heart attacks and sudden death.

The risk of death from drug-cated stents, however, is less than one in 200, experts say. But with the sheer number of stents going into patients each year--one million in the U.S., and twice that number worldwide--death risk is not a trivial matter.

Fortunately, a combination of two anticlotting drugs -- aspirin and Plavix -- cuts the risk from drug-coated stents. Doctors used to wean stent patients off these drugs after six months, but studies now suggest that patients should remain on anticlotting drugs for at least a year.

However, patients with bleeding problem, or those who need surgery, cannot always tolerate long-term anticlotting treatment.

FDA Probes Safety Risks of Drug-Coated Stents

2. HPV Vaccine

One of the biggest health stories of 2006 marked a major milestone for women's health: FDA approval of Gardasil, a vaccine that protects against two strains of human papillomavirus, the viruses that cause cervical cancer. (The vaccine also protects against two HPV strains that cause genital warts.)

HPV is a sexually transmitted infection, which means it can affect males as well as females. The vaccine does not stop HPV from causing cervical cancer or genital warts in a person already infected, but will protect girls and women from catching HPV in the first place.

For this reason, the vaccine--approved for girls and women aged 9 to 26--has been recommended as a routine immunization for girls aged 11-12. The recommendation to vaccinate young girls against a sexually transmitted disease has caused some controversy, but the Centers for Disease Control's Advisory Committee on Immunization Practices has provisionally put the HPV vaccine on the childhood vaccination schedule. (This decision is still under review by the Department of Health and Human Services.)

Women who are sexually active are also strongly advised to get the vaccine. However, the vaccine does not protect against all strains of HPV, so regular cervical cancer screening and HPV testing is still necessary.

HPV Vaccine Will Slash Cervical Cancer Deaths, Drugmaker Says

1. Global AIDS Pandemic

Twenty-five years after the first AIDS cases was reported in 1981, the global AIDS pandemic has killed 25 million people. Currently, 40 million people--an exponentially increasing number of them women and children--are infected wtih HIV worldwide.

While 2006 saw dramatic developments and breakthroughs in the effort to develop an AIDS vaccine, make antiretroviral medications more available in developing nations and improve public health education and cultural attitudes that also play a role in the transmission of the disease, the virus continues its devastating rampage through Africa, Asia, India and eastern Europe.

As 2006 came to a close, a South African report predicted that fewer than half of South Africa's current 15-year-olds would live to see their 60th birthday because of HIV/AIDS. Another report issued in 2006 said that AIDS, currently the fourth top cause of death worldwide, would jump to number three within the next 25 years.

AIDS Will Kill Half of South Africa's Teens Before They Reach Age 60

As public health officials grapple to contain the global pandemic, the virus remains persistent in the United States as well. According to the CDC, 1.1 million Americans are infected with the AIDS virus, with about 40,000 new cases reported each year. The CDC also estimates that about 250,000 American have HIV but don't know it yet.

In 2006, the CDC made historic news when it recommended universal AIDS testing. In the past, being tested for HIV was entirely voluntary. Under the new CDC recommendations, doctors will routinely test patients for HIV unless that patient specifically opts out.

Americans Should Be Tested Routinely for HIV, CDC Says

Web MD reporter Daniel DeNoon and the Associated Press contributed to this report.