By Stephen Smith, Globe Staff

Laboratory testing confirmed today that a 13-year-old Worcester boy with persistent health problems died from swine flu, the first Massachusetts youth to succumb to the novel virus that has killed more than 200 people in the United States, public health authorities reported this evening.

Authorities also said preliminary testing strongly suggests that the death of a 64-year-old Worcester County man was caused by the virus known by the scientific name H1N1. With the two deaths in Worcester -- which are unrelated -- Massachusetts has recorded six swine flu deaths since the virus was first detected in the state in late April; the four other deaths were in Boston.

The teenager, who died last week, had underlying medical conditions that made him more susceptible to complications from the viral illness, said John Auerbach, the state's public health commissioner. Because of patient confidentiality laws, the Department of Public Health declined to identify the teen or to delineate his medical problems.

Disease trackers have reported that swine flu appears to present the most dire threat to children with asthma, diabetes, or neurological conditions such as muscular dystrophy. "Unfortunately, for some children and particularly those children who do have certain kinds of underlying health issues, it can be quite risky," Auerbach said.

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Hospitalizations for children diagnosed with obesity almost doubled between 1999 and 2005, a new national study reports. Costs have almost doubled too, even though federal figures measuring the prevalence of childhood obesity appeared stable over the same period of time.

A research team led by Dr. Leonardo Trasande of Mount Sinai School of Medicine tracked the increase in hospitalizations of children and adolescents from 2 to 19 years old by analyzing records from the Nationwide Inpatient Sample, the largest database for US hospitalizations. The researchers included obesity as a primary diagnosis as well as obesity when it was secondary to another medical condition, such as asthma, diabetes, or a mental illness.

Hospital stays for these children climbed from 21,743 in 1999 to 42,429 in 2005 while costs in constant dollars rose from $126 million to $238 million. The most common conditions the children had along with obesity were psychiatric disorders, pregnancy-related conditions, asthma, and diabetes. The increase in obesity diagnoses could not be explained by increases in the other conditions, which decreased or stayed the same, except for diabetes.

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By Kay Lazar
Globe Staff

The deaths of two more Boston residents have been linked to swine flu, Boston health authorities reported tonight, bringing to four the number of Massachusetts adults killed by the novel virus.

The victims, both men, were 52 and 30 years old.

The 52-year-old had underlying medical conditions that might have made him more susceptible to complications from the germ, known scientifically as H1N1, but the younger victim did not, said Boston Public Health Commission spokeswoman Susan Harrington. She declined to elaborate, citing patient confidentiality laws.

Test results confirmed today that the 52-year-old, who died last Friday in his home, was infected with the virus.

The 30-year-old was hospitalized two weeks ago and died Monday; preliminary tests strongly suggest he harbored H1N1. Tests designed to confirm his infection are pending in Atlanta at the US Centers for Disease Control and Prevention.

Since the arrival of the virus in Massachusetts in April, Boston appears to have borne a disproportionate share of the illness, said Barbara Ferrer, executive director of the Boston Public Health Commission. In addition to all four of the state's swine flu-related deaths, the city has recorded 475 of the 1,287 cases of swine flu confirmed in the state.

"Boston has about 11 percent of the state population but roughly 30 percent of the H1N1 confirmed cases," Ferrer said.

That ferocity has perplexed disease specialists.

"We are going to need to work closely with the state and CDC to understand the pattern of H1N1," Ferrer said. "As with any urban city, people live in much closer proximity with each other and given this is transmitted through respiratory droplets, that proximity is worth noting. The density in Boston is much greater than the density in a Webster or Wayland."

Earlier this week, health authorities reported that the virus had killed an 84-year-old Boston resident. The state's first swine flu victim was a 30-year-old mother from Boston who died June 14. Like the 30-year-old man who died on Monday, the woman suffered from none of the underlying medical conditions -- such as heart disease, asthma, diabetes, or cancer -- that can turn a relatively mild viral infection into a life-threatening illness, city disease trackers said.

Despite the four deaths, surveillance data show that for the first time since the virus hit the state, there is decreasing illness linked to influenza in Boston and across Massachusetts. Still, the level of flu activity is much higher now than normal for summertime.

Nationwide, the germ has proved most troublesome to younger adults and children, unlike the seasonal flu, which disproportionately harms the aged. More than two-thirds of the confirmed illnesses in Massachusetts have been in people under 25.

Some disease specialists theorize that older people may have added protection because they were exposed to H1N1 viruses circulating widely from 1918 to 1957, before those strains vanished for two decades. Other H1N1 strains have been circulating in recent years, however.

In this swine flu outbreak -- there have been more than 21,000 confirmed cases nationwide -- the vast majority of illnesses have been mild. But officials are concerned that the strain might re-emerge in the fall, possibly in a more virulent form.

Citing that possibility, Senator Richard T. Moore, an Uxbridge Democrat who chairs the legislature's Health Care Financing Committee, yesterday sent a letter to state public health Commissioner John Auerbach asking how various Massachusetts health and educational agencies are coordinating strategies to help protect the state's one million school-aged children.

State public health spokeswoman Jennifer Manley said preparing for the fall is a "high priority" for the department. She said Auerbach was unavailable to comment because he was flying back last night from the CDC in Atlanta, where he discussed this issue and other swine-flu related concerns with federal officials and health directors from around the country.

"It will be a busy summer of planning as we work with our partners in health care, in government, and with the public to prepare for the upcoming flu season," she said.

By Elizabeth Cooney
Globe Correspondent

The nation's obesity crisis has hit Massachusetts hard -- just not as hard as the rest of the country, according to a study that takes the measure of the nation's waistline.

About 21 percent of adults in the state are obese, a figure that, while alarming, is among the lowest in the country (only Colorado is lower). But the state's children do not share that distinction: At 30 percent -- a rate that combines overweight and obesity -- they are among the middle of the pack nationally as the state prepares to begin screening children to determine if they weigh too much.

The troubling numbers come from an annual analysis released today by the Trust for America's Health and the Robert Wood Johnson Foundation, a philanthropy focused on health. The report, based on federal data gathered differently for adults and children, also sounds an alarm about aging and overweight Baby Boomers.

"Although we are ranked relatively well for our adults, it's an issue we are very concerned about," said John Auerbach, commissioner of the state Department of Public Health. "We have about 60 percent of adults who are overweight and that's not a statistic we are proud of, even if we look better than most of the country. That's not a good statistic, and obviously we are concerned about the percentage of children who are overweight."

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Clearing the way for HIV testing to become almost as routine as checking for cholesterol, state public health officials issued an advisory today saying that the written consent required by law can be included in general permission forms patients sign for medical care.

The new advice, issued by the state Department of Public Health, recommends testing adolescents and adults from 13 to 64 years old in all heathcare settings, no matter what brings them to the hospital or doctor's office. People who fall into high-risk categories should be screened annually for HIV, the virus that causes AIDS.

The new directive brings Massachusetts closer to federal guidelines promoted by the US Centers for Disease Control and Prevention in 2006 as a way to reduce the spread of HIV. People who do not know they are infected -- estimated to be about a quarter of cases -- account for the majority of new HIV transmission, Kevin Cranston, director of the state's Bureau of Infectious Diseases, told the state's Public Health Council today.

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A Boston organization that works to improve children's health has won a $3.25 million grant to fight childhood obesity by enlisting healthcare professionals to become community advocates for local changes.

The National Initiative for Children’s Healthcare Quality will use the money from the Robert Wood Johnson Foundation to train and connect healthcare providers as they work on policies and environmental changes that foster healthier eating and more physical activity. Increasing the availability of fresh fruits and vegetables or providing safe routes for children to walk to school are two examples of the kind of changes the grant is intended to encourage, project director Rachelle Mirkin said.

The National Initiative for Children’s Healthcare Quality will work with the American Academy of Pediatrics and the California Medical Association Foundation on the project. The program is seeking nominations for communities and will make choices based on the level of need, particularly in underserved populations, and programs already in place, Mirkin said.

By Stephen Smith, Globe Staff

A 30-year-old Boston woman is the first Massachusetts resident to die from swine flu, health authorities reported this afternoon.

The woman, whose identity was not disclosed because of patient confidentiality laws, arrived at a Boston hospital already seriously ill on June 5, spent time in an intensive care unit, and died yesterday.

An investigation by the Boston Public Health Commission is ongoing, but the agency's executive director said a preliminary review showed that the woman had experienced other health problems. It remained unclear, though, whether those medical issues might have made the woman more susceptible to complications from the virus, known by the scientific name H1N1.

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By Stephen Smith, Globe Staff

While swine flu appears to be abating in many states, the novel virus is causing an increasing level of respiratory illness in New England and elsewhere in the Northeast, federal disease trackers reported this afternoon.

The new leader of the US Centers for Disease Control and Prevention, Dr. Thomas Frieden, said it was unclear why the Northeast corner of the country was experiencing a higher level of transmission. "Influenza is one of -- if not the most -- unpredictable infectious diseases," said Frieden, formerly the top health officer in New York City. A nationwide network of doctors and medical clinics provide regular snapshots of the virus' spread.

As of today, 1,153 cases of the disease had been confirmed through laboratory testing in Massachusetts, although disease specialists said they suspect that is only a small fraction of the total. So far, 80 patients have been so ill that they needed to spend at least one night in a hospital. More than three-fourths of the confirmed cases in the state have been reported in children and young adults.

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By Stephen Smith, Globe Staff

Public health authorities in Boston announced this morning that they are temporarily closing the city's biggest charter school, Boston Renaissance, for a week because of a suspected outbreak of swine flu.

Classes are being suspended at the Theater District school starting tomorrow and are expected to resume June 4. The closing was prompted by an unusually high number of absences in recent days, the Boston Public Health Commission said.

State health authorities reported this afternoon that 63 more Massachusetts residents have confirmed cases of swine flu, bringing to 413 the total number of infections identified in the past month.

None of the newly confirmed cases required hospitalization.

Nearly three-quarters of all swine flu patients in the state live in just two Boston-area counties, Middlesex and Suffolk.

Boston Renaissance is the eighth public or private school in the city to be shuttered because of swine flu fears. The city's largest public school, Boston Latin, resumed classes today after being closed for a week.

Two other schools, the John D. O'Bryant School of Mathematics and Science in Roxbury and the James Condon Elementary School in South Boston, began weeklong closings today and will remain closed until next Wednesday, June 3.

The Umana Middle School Academy in East Boston and Frederick Middle School in Dorchester were closed last week when students began falling ill, as were two private academies: the Winsor School and the British school.

Perceptions of racism -- from being treated with suspicion in a store to unfairness in employment or housing -- can heighten stress levels and affect health, research has shown. A new study from Boston University links these smoldering signs of racism to weight gain in black women, suggesting a possible explanation for the their higher obesity rates compared to white women.

Yvette Cozier, an epidemiologist at the Slone Epidemiology Center at BU, led a survey of more than 43,000 women enrolled in the long-running Black Women's Health Study. Writing in the June issue of Annals of Epidemiology, she and her co-authors describe participants' reports on their weight, body mass index, and perceptions of racism.

At the beginning of the eight-year study, the women were asked if they sometimes felt they were treated poorly in a restaurant or store, whether they thought people considered them dishonest or less intelligent, and if they had felt unfairness on the job, in housing, or from police. The women, 21 to 69 years old at the study's outset, were placed in four groups based on how frequently they said they experienced these signs of racism. Their weight was recorded every two years from 1997 through 2005. Their waist circumference was measured at the beginning and end.

At the end of the trial, all the women had gained weight. But the women who said they felt higher levels of racism gained more weight and had bigger waist-size increases compared to the women who felt the least racism. That held true after accounting for factors such as education, geographic region, and beginning body mass index.

"Racism is real and it has real effects," Cozier said in an interview. "It can result in real changes in the body."

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By Stephen Smith, Globe Staff

State disease investigators reported this afternoon that 66 more Massachusetts residents have confirmed cases of swine flu and that seven of them required hospitalization.

Since the novel virus that causes the disease arrived in the state a month ago, 350 infections have been confirmed by laboratory testing, and 26 patients have been so ill that they had to be hospitalized for at least one night. More than two-thirds of the cases in Massachusetts have been reported from two Boston-area counties, Middlesex and Suffolk, and three-fourths of confirmed illnesses are in people 20 and younger.

The number of confirmed cases, specialists said, likely reflects only a small fraction of illnesses caused by the H1N1 virus. Many other people, doctors said, have probably experienced bouts of sickness caused by the germ but their symptoms were sufficiently mild that they did not seek medical attention and, thus, were not tested.

By Stephen Smith, Globe Staff

Boston public school authorities this afternoon decided to temporarily suspend classes at two more schools because of outbreaks of fevers and coughs suspected to be caused by swine flu.

The John D. O'Bryant School of Mathematics and Science in Roxbury and the James Condon Elementary School in South Boston will be closed starting Wednesday and reopen June 3.

The O'Bryant school has more than 1,200 students in the seventh through 12th grades, while Condon has 700 students in kindergarten through fifth grade. A significant number of students from both schools were reported as being ill today, according to the Boston Public schools.

Three Boston schools were shuttered last week -- Boston Latin School, Umana Middle School Academy, and Frederick Middle School -- because of flu outbreaks. Latin reopens tomorrow, while Umana is scheduled to resume classes Thursday and Frederick on Friday.

By Stephen Smith, Globe Staff

State health authorities reported this afternoon that 49 more Massachusetts residents have been definitively diagnosed with swine flu, bringing to 284 the number of cases identified in the past month.

One of the patients with a newly confirmed infection required hospitalization. The majority of cases -- 31 -- were from Middlesex and Suffolk counties, with three of every four patients younger than 21.

By Stephen Smith, Globe Staff

State disease investigators reported this morning that they have confirmed 42 additional cases of swine flu in Massachusetts, bringing to 235 the total number of illnesses identified since the virus arrived late last month.

Four of the patients with newly confirmed infections were hospitalized.

More than three-fourths of the cases in Massachusetts, reflecting findings nationwide, are in children and adolescents.

Middlesex County accounts for far more cases -- 130 -- than any other county in the state.

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A spike in absences of students with flu-like symptoms prompted officials to shutter The Fessenden School in Newton for a week, bring the tally of local school closures to four this week.

See the story here.

By Stephen Smith, Globe Staff
and Elizabeth Cooney, Globe Correspondent

Boston's biggest public school, Boston Latin, will be shuttered for a week in hopes of halting a suspected outbreak of swine flu, city authorities announced today. The decision came after more than 250 students called in sick or were sent home because of respiratory symptoms.

In a hastily arranged City Hall press conference, Mayor Thomas M. Menino, flanked by his top health and school administrators, acknowledged that the move was inconvenient for Latin's 2,400 students and their families. But by tonight, definitive testing confirmed that one student has the disease, and preliminary results on a handful of other youths strongly suggested they, too, are infected.

Minutes after the temporary closing of Latin was announced, the Boston Public Health Commission disclosed that classes were also being suspended for a week at an all-girls private academy just blocks away, the Winsor School, after a cluster of flu symptoms emerged there. Today, 34 of 430 students were absent.

Earlier today, a private school in Wellesley, the Dana Hall School , cancelled classes for a week after 100 students and teachers developed fevers, sore throats, and other flu-like symptoms.

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By Stephen Smith, Globe Staff

State laboratory tests show that 26 more Massachusetts adults and children have swine flu, with two of the newly diagnosed patients requiring hospitalization, the state Department of Public Health reported this afternoon.

Since the virus first appeared in the state late last month, a total of 167 infections have been confirmed, with 100 of those patients living in Middlesex County. A total of 13 patients have been admitted to hospitals for treatment, although all have recovered.

Only seven states have reported more cases of the disease, caused by the H1N1 virus.

The state Department of Public Health today confirmed 13 new swine flu cases in Massachusetts, bringing the total count to 101. All of the new H1N1 flu cases are expected to recover, according to an update posted on the agency's website; one person was hospitalized but has been discharged.

Health officials encouraged residents to take precautions, including frequent hand-washing with soap and warm water or use of an alcohol-based gel; covering your mouth when you cough with a tissue or your inner elbow (not your hands); and staying home from work or school if you're sick.

By Stephen Smith, Globe Staff

Public health authorities reported this morning that 26 more Massachusetts residents have confirmed cases of swine flu, bringing the state total to 71 since the virus first appeared in the state less than two weeks ago.

All but two of the newly identified patients were children or teenagers; the other two patients are in their 20s. Only one of the patients -- a baby -- required hospitalization, and that child has recovered. The new cases were predominantly in Eastern Massachusetts.

Data released this morning by the US Centers for Disease Control and Prevention show that only four states -- California, Illinois, New York, and Texas -- have recorded more cases of illness caused by the H1N1 virus that is responsible for swine flu. It's unclear whether that indicates the virus is truly more pervasive in those states or if it reflects more aggressive testing, particularly in Massachusetts.

Public health officials are no longer recommending that schools close when swine flu cases are confirmed, because the virus appears no more serious than the seasonal flu, and it is now so widespread that shutting schools won't stop its spread.

By Stephen Smith, Globe Staff

Eleven more Massachusetts residents -- nearly all in their teens or younger -- have confirmed cases of swine flu, state public health authorities announced today.

That brings to 45 the total number of children and adults whose illnesses have been traced to the H1N1 virus that causes the disease. None of the people whose cases were confirmed by state laboratory testing yesterday had to be hospitalized.

Nationally, 642 cases of the disease, caused by a novel virus, have been identified. Only Arizona, California, Illinois, New York, and Texas have reported more cases than Massachusetts.

State public health authorities no longer recommend that schools and day care centers shut down if any of their students are diagnosed with swine flu, according to an update released this afternoon that follows a change in guidance made by the US Centers for Disease Control and Prevention.

Instead, the Massachusetts Department of Public Health recommends that all students with symptoms of the flu stay out of school and school-related activities while they are ill and recovering. Schools should urge parents to keep their children home if they have flu symptoms and send home any sick child who does come to school, the state advisory said.

Some schools, including Lexington, Norfolk, and Newton, have sent messages to residents explaining their decision to stay open. Three high school students in Lexington who traveled to Costa Rica on the recent school vacation were diagnosed with swine flu, but have since recovered from what the letter called mild cases. In Norfolk, one case of swine flu was confirmed and the school the student attended was cleaned on a scheduled day off. In Newton, one student was diagnosed with a probable case.

By Stephen Smith, Globe Staff

Governor Deval Patrick announced tonight that tests have confirmed swine flu infections in 34 Massachusetts adults and children, up from six last week.

Only three of the patients were ill enough to be hospitalized. They have since recovered. The majority of patients, 18, have been children.

“This is a cause for concern but not for panic. Flu always spreads,” the governor said at a Beacon Hill news conference.

While swine flu has spread across the state, health authorities said that so far it has caused relatively mild illness. Nationally, only one death has been reported, and that involved a child brought to Texas for treatment from Mexico, where the outbreak began and has been more serious.

But state public health officials continued to urge the ill to stay home from work and school and cautioned that because the outbreak is less than two weeks old, they remain unable to predict its course.

Patients and staffers at a New Hampshire hospital where two healthcare workers have probable cases of swine flu are being monitored while a state official said there is no connection between the two employees.

Concord Hospital is offering antiviral medications to five patients and seven employees who came in close contact with one hospital employee who developed flu symptoms this week while at work. Both workers at the 238-bed hospital tested positive for type A influenza, and their results have been sent to the US Centers for Disease Control and Prevention to determine whether they have the H1N1 strain of flu that has spread around the world.

"A full investigation is going on at the hospital, where we review the records of what patients were there, what family members were visiting that patient, who was staying overnight, as well as the healthcare workers that were in close proximity," Dr. Jose Montero, director of the New Hampshire Division of Public Health Services, said. "We're doing an assessment of all of them to see if anyone has developed any symptoms."

The first worker to fall ill did not come to work while symptomatic. A third worker is being tested after showing signs of flu, but those preliminary results are not in yet.

Neither of the first two employees had any connection to each other or to Mexico, adding to evidence that the illness is spreading widely within the borders of the United States.

"We are not interpreting these two cases as transmission within the hospital walls," he said. "We do believe there was community transmission. These people were exposed to somebody who gave it to them. We don't know who that was."

By Stephen Smith, Globe Staff

As many as nine Harvard School of Dental Medicine students may be infected with swine flu, Boston health officials announced this afternoon.

The students, in their third and fourth years on the Longwood area campus, were involved in treating patients at the school's dental clinic, although disease trackers do not know precisely how many. Authorities from the university and the city are identifying those patients and contacting them, they said.

Dr. Anita Barry, director of Boston's infectious control bureau, estimated that no more than 20 patients had contact with the contagious students at the clinic. Barry said it's unlikely that the patients were actually exposed to the virus, in large part because dental students typically don masks, gowns, and gloves.

Still, the Boston Public Health Commmission and Harvard have decided that Harvard dental students as well as Harvard medical students involved in patient care will be banned from hospitals and clinics until Wednesday. Harvard officials said they do not expect the decision to keep students out of clinics to have a significant impact on patient care.

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The International Association of Emergency Managers, Universities and Colleges Committee has posted a map of reported cases of swine flu at higher education institutions in the United States, including and Harvard's dental school and Amherst College.

The information is based on an institution's web site, press release, or other official communique.

Nine students at Amherst College who have tested positive for type A influenza are being treated as if they have the swine flu strain, being isolated in a dorm for up to seven days and taking antiviral medications.

While no cases have been confirmed, two are called probable cases of the strain that is spreading around the world from its epicenter in Mexico. None of the students had traveled to Mexico or could recall having contact with anyone who had been there, the college said.

The students are responding "very well" to the flu medications, college spokeswoman Caroline J. Hanna said today. Their meals are being brought to them in the small, previously unoccupied dorm and they are not attending classes.

The students came to the college's health center earlier this week with mild flu-like symptoms. Rapid tests there, including two last night, indicated they had type A influenza. Hanna declined to give any details about where the students lived or what classes they take.

Two of the samples were then sent to the state Department of Public Health, which characterized them as probable and sent them to the US Centers for Disease Control and Prevention for further testing, Hanna said. The school didn't submit the other samples because it didn't want to overload the already backed-up testing labs.

"Had there been no discussion of swine flu, .... it would just have been treated as a normal type flu," Hanna said, "Our health services said, 'Maybe we should take a second look and let's just be cautious and get this tested.' "

The 1,700-student college in Western Massachusetts has canceled social events but not classes and is setting up additional hand-sanitizing stations at dorms and other buildings on campus, beyond the waterless dispensers already at its fitness center and dining halls. Custodians are doing additional cleaning in the health services building.

Students are encouraged to keep six feet away from anyone who is coughing, sneezing, or showing other signs that look like flu, health director Dr. William H. Morgan said in a message to the college community.

By Stephen Smith, Globe Staff

Boston health authorities tonight closed the Harvard dental school's treatment clinic and the university temporarily shut the dental school as a precaution after a third-year student developed "a probable case" of swine flu, city and state health officials announced at a hurriedly called news conference.

Disease investigators from the Boston Public Health Commission are reviewing whether the student treated patients at the Longwood Avenue clinic, and tracking down any students and faculty members who might have had contact with him. The clinic treats about 50 patients a day, and the dental school has more than 200 students, faculty and other staff members.

The commission said it closed the Harvard Dental Center until the extent of the illness could be determined. The officials said they had also requested cancellation of classes for third- and fourth-year, and post-doctoral students and urged those students, and their teachers and staff to stay at home for now.

"We are all concerned, but there's no need for panic," said Dr. David Rosenthal, director of Harvard University Health Services.

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Eighty-eight children stayed home today from a Spencer elementary school attended by two children who were being tested for swine flu, four to five times the usual absentee rate.

But late this afternoon a school official received word that the tests were negative for flu.

"The kids are free and clear," Superintendent Ralph E. Hicks said.

The Lake Street School siblings were tested by their pediatrician at the Fallon Clinic in Auburn after feeling sick at school Tuesday. Just before 5 p.m. today Hicks received a letter from the clinic saying the tests were negative for influenza.

When flu is suspected, a preliminary test is done to establish whether the flu virus is present in swabs taken from patients. Later tests determine the strain of flu, including swine flu.

The siblings, whose names are being withheld by school authorities, had gone to school Monday and Tuesday before falling ill. After one child reported feeling sick Tuesday morning, the school nurse called the children's mother and recommended they both visit their pediatrician and be tested for flu. The other child also felt unwell. The family had spent last week's school vacation in Mexico, the epicenter of an outbreak of swine flu that has spread around the world.

After consulting with town and state public health officials, Hicks decided to keep the school open until test results determined whether the children, in second and third grade, had the swine flu.

A letter went home to parents Tuesday explaining that their two classrooms and common areas in the school as well as the bus they rode had been disinfected. The school has 399 pupils in grades 1 through 3.

"We don't take this mildly," he said in an interview before the test results were known. "I can understand the concern [but] I don't see panic. These kids were not taken out in an ambulance and it's not like they were violently ill. They were moderately ill."

By Bina Venkataraman, Globe Correspondent

Q. How do people catch the swine flu?

A. Public health officials believe the swine influenza A (H1N1) virus is spreading the way that the seasonal flu spreads every year -- when people infected with the flu cough or sneeze and others breathe in airborne droplets containing the virus. People may also be getting swine flu from touching surfaces such as doorknobs contaminated with the virus and then touching their face or mouth. Infected people can spread the flu before they have symptoms, as well as while they are sick.

Q. How can I protect myself and my family from swine flu?

A. Wash your hands frequently with soap and water. Also, you should get plenty of sleep, exercise, manage your stress, eat healthy food, and drink plenty of water. Avoid close interactions with people who are sick and try not to touch surfaces that could be contaminated with the virus. Avoid touching your nose, eyes, or mouth.

Q. Does hand sanitizer work if I can’t wash my hands?

A. Doctors advise using sanitizing wipes and alcohol-based gels when you do not have access to soap, water, and a sink. If you use a gel, rub your hands until it dries. It’s preferable to wash your hands.

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By Bina Venkataraman, Globe Correspondent

When it comes to epidemics, history can teach -- or mislead.

In the winter of 1976, when more than 200 soldiers came down with a bad flu at Fort Dix, NJ, and one died, people around the country panicked. The Ford administration quickly responded to fears of a pandemic influenza -- mindful of the flu that had swept the world and killed millions in 1918 -- by vaccinating more than 40 million Americans, nearly a quarter of the population.

But the pandemic never happened. And the vaccine probably caused more than 500 people to suffer a neurological disorder that can result in paralysis, and it cost the federal government millions of dollars in damages.

Past disease outbreaks can be instructive for public health officials responding to the strain of swine flu that has led to at least 140 deaths in Mexico City and more than 40 confirmed cases in the United States. But the nature of epidemics is that they are unpredictable, say several leading public health figures, and drawing too many comparisons to past experience poses its own dangers.

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By James F. Smith, Globe Staff

The winter flu season was winding down in Mexico and the number of cases should have been going down, too. But a high-tech command center in Mexico City, linking a nationwide network of 11,000 disease surveillance units, was picking up unusual signs of an uptick.

That triggered an investigation that isolated a new human virus. Then scientists in Canada quickly carried out complex genetic sequencing, and within a couple of weeks, researchers had unraveled the mystery of a new influenza virus that was spreading among humans, with potentially global consequences.

Dr. Julio Frenk, the former Mexican national health minister who is the new dean of the Harvard School of Public Health, said the 25-year-old Mexican surveillance system had worked just as it was designed to do, contributing to a sense of comparative calm in the Mexican capital though the swine flu has been blamed for 149 deaths in the country.

"People are responding very well," Frenk said in a telephone interview today from the capital. "The fact that the president himself has been leading the response to the emergency has sent a clear signal that this is very serious, and everyone needs to cooperate. The mood is: everyone wants to do his or her part in assuring that we bring this emergency under control."

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By Kay Lazar, Globe Staff

As Mexican officials report a swine flu death toll of 149 and counting, and the number of confirmed cases in the US doubles, state public health officials said today they are mobilizing a vast network of disease trackers to detect and treat the illness.

State Public health Commissioner John Auerbach said the state is on "high alert," sending information to thousands of physicians, hosptials, day care providers and other health care centers about vigilantly watching for signs and symptoms of the disease.

State officials said today they have alredy ruled out swine flu in several of the two dozen people who displayed symptoms possibly consistent with the illness. There are no confirmed cases in the state or region, they stressed.

The state has accepted the federal government's offer of anti-viral medications to be shipped from the national stockpile, medicine that should be in state by the end of the week. Massachusetts already has 50,000 courses of anti-viral medication at the ready, Auerbach said.

One of the state's largest medical practices -- Harvard Vanguard -- said it is ramping up its electronic system of 400,000 patient medical records to scan for any uptick in influenza like illness. Boston health officials say they have a 24-hour monitoring system in place, and cautioned against panic.

Barbara Ferrer, executive director of the Boston Public Health Commision, said her office is working closely with the superintendent of Boston Public Schools to monitor potential illnesses.

"We’ll be reviewing on a case by case situation where children may be infected," she said.
"It’s all a matter of where those children have been, were they even in school at the time they were potentially infectious, and who else they came in contact with."

By Stephen Smith, Globe Staff

Those Hollywood types had it all wrong. If you want to find a Boston neighborhood where everybody really does know your name, skip Beacon Hill (home of the mythical "Cheers" bar). Head to Charlestown.

It turns out that Townies, as they are called, are more likely to have a bounty of neighborhood chums than people in any other corner of the city. That's the conclusion of the annual "Health of Boston" report released today by the city's Public Health Commission.

That study chronicles a broad sweep of human health. Much of it is grim -- the number of babies who die before their first birthday, adolescents who kill themselves, adults who drink too much -- but it also measures some of what's best about Boston, including friendship.

Last year, residents from 16 neighborhoods were asked: "Not counting the people who live with you, how many friends live in your neighborhood?"

Citywide, 67 percent said they had three or more friends in their neighborhood. In Charlestown, it was 91 percent. Next was South Boston, with 81 percent. In the Fenway only 42 percent claimed a broad circle of pals.

Charlestown has long been portrayed in exaggerated images, everything from hoodlum haven to yuppie refuge. But there's no denying it is its own community, physically separated from the rest of Boston.

Beth Rosenshein has worked there for 12 years, lived there for five. "There is," she said, "some sense of family here that goes beyond the common definition of family."

By Stephen Smith, Globe Staff

Three more suspected cases of mumps were reported today to Boston health authorities, who said one of the patients had no obvious connection to Northeastern University, epicenter of a cluster of illness that surfaced last week.

So far, one case of the viral disease has been confirmed by laboratory tests while results are pending for 10 more patients whose symptoms suggest they have mumps, according to the Boston Public Health Commission. Telltale signs of the disease include facial swelling, fever, headaches, muscle pain, fatigue, and loss of appetite. The germs can spread via coughing, sneezing, or talking.

The one patient without an established link to Northeastern was diagnosed at a community health center in Boston, said Ann Scales, chief spokeswoman for the health commission.

By Stephen Smith, Globe Staff

The number of Northeastern University students suspected of being sick with the mumps rose to nine this evening, with one suffering symptoms sufficiently severe to require hospitalization, Boston public health authorities said.

The students bear the telltale signs of the viral illness, including facial swelling, fever, headaches, muscle pain, fatigue, and loss of appetite. The germs can spread via coughing, sneezing, or talking.

All nine students are undergraduates, and they range in age from 18 and 22, said university spokesman Mike Armini.

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By Patricia Wen, Globe Staff

Four Northeastern University students have suspected cases of the mumps, Boston public health officials announced this afternoon, and they urged any unvaccinated students and staff to get immunized against this once-common childhood illness.

Though laboratory results are not yet back to confirm these as mumps cases, Dr. Anita Barry, director of infectious diseases at the Boston Public Health Commission, said the four students -- two of whom just returned from Ireland where there was a recent mumps outbreak -- have symptoms that are consistent with mumps. Given the relative ease with which this illness can be spread, she said, "it's likely we'll see more cases."

Mumps is caused by a virus that is spread through infected respiratory tract secretions, and people typically catch it by being within three to six feet of an infected person who coughs or sneezes. However, it is difficult to tell whether someone is infectious or not.

Barry said people are generally considered to be infectious from three days before until five days after the onset of swelling of the salivary glands. She said most infected people often feel sick for a few days with low-grade fever and "look like chipmunks."

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By Liz Kowalczyk, Globe Staff

State public health officials have cited Beth Israel Deaconess Medical Center for serious problems with its infection control practices, after 18 mothers and 19 infants contracted antibiotic-resistant staph infections over the past six months.

Eight of the mothers and two infants had to be hospitalized for treatment of their bacterial infections, including two with serious complications, according to a news release this morning from the state Department of Public Health. All patients have since recovered.

As a result of the large number of infected patients, the most recent of which occurred this week, health officials inspected the hospital last month and found significant lapses in the hospital's policies for preventing infections and training employees.

The problems are not believed to be related to the staph infections, however. Officials have not identified the source of the outbreak and have called in specialists from the US Centers for Disease Control and Prevention to help investigate. Inspectors from the federal Centers for Medicare & Medicaid Services also will conduct a comprehensive review of quality care practices at the hospital in coming weeks.

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By Stephen Smith, Globe Staff

Public health regulators this morning unanimously approved screening Massachusetts students to determine if they are overweight, part of a major campaign to shrink bulging waistlines and stem obesity-related diseases once rarely seen in the young.

The vote by the Public Health Council -- an appointed board of doctors, academics, and service providers -- means that starting in the fall, public schools across the state will begin measuring and weighing first-, fourth-, seventh- and 10th-graders. Parents who do not want their children screened will be able to opt out.

The screenings will be phased in during the next two school years, with more than 286,000 students expected to have undergone evaluation by the end of the 2010-2011 academic year.

Parents will receive a report telling them how their children fared on the body mass index, a standard measurement used to analyze if someone weighs too much or too little. The report will also include recommendations on dealing with a child's weight problem, including a suggestion to visit the pediatrician.

"We think it would be a mistake to just send home a number and leave parents hanging without providing an interpretation," said Dr. Lauren Smith, medical director of the state Department of Public Health.

The initiative is modeled on programs in Arkansas and New York City schools that have been calculating the body mass index of students for several years.

By Stephen Smith, Globe Staff

An outbreak of vomiting and diarrhea at Babson College appears to be slowing significantly, state disease trackers reported this afternoon.

The college in Wellesley closed its campus Saturday after more than 100 students fell ill with a gastrointestinal ailment believed to be caused by norovirus, a germ that spreads quickly and ferociously. By Sunday, the number of new cases had declined dramatically: An advisory from the college reported that only four students visited the campus infirmary Sunday, with four others calling in for medical advice.

While norovirus can provoke decidedly unpleasant symptoms, it rarely causes significant health problems and typically lasts no longer than a day or two. The virus spreads when people don't wash their hands thoroughly after using the restroom and when food-service workers don't follow proper hygiene practices.

Hoping to contain the outbreak, the college decided to cancel classes, sporting events, and all other meetings until Wednesday morning.

By Stephen Smith, Globe Staff

A Suffolk Superior Court judge ruled today that Boston has the legal authority to ban blunt wraps, tobacco-based rolling papers, from all store shelves across the city. Blunt wrap makers had sued to overturn the prohibition, arguing that city regulators were unconstitutionally picking on them.

The February ban on blunts was part of a broader regulation strengthening Boston's tobacco control ordinances, giving the city some of the nation's toughest antismoking regulations. A key rule eliminates cigarette sales in pharmacies and in stores on college campuses, but allows other retailers to continue selling tobacco products -- except for blunt wraps.

Three major blunt wrap manufacturers -- as well as their trade organization, the RYO (as in, roll your own) Cigar Association -- sued the city, complaining that their products had been unfairly singled out for a comprehensive ban.

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By Stephen Smith, Globe Staff

President Obama this evening nominated Dr. Howard Koh, an associate dean at the Harvard School of Public Health and former Massachusetts public health commissioner, to a top health position in his administration.

As an assistant secretary for health, Koh would be responsible for establishing the nation's public health agenda if confirmed by the Senate.

He is the second member of his family to be nominated to a top Obama administration post this week: On Monday, his brother, Yale Law School Dean Harold Koh, was picked to be the State Department's legal adviser, a post that also requires Senate approval.

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The Framingham Heart Study, famous for its lessons about high blood pressure and cholesterol gleaned from generations of the town's volunteers, is searching for a new way to predict who might be at high risk for heart disease and stroke.

The 60-year-old study announced today that it would partner with Waltham-based BG Medicine in a five-year project to study blood tests and other medical records from more than 7,000 participants. They hope to discover substances in the blood that may be linked to heart disease and metabolic syndrome, a collection of risk factors such as obesity and high blood sugar that can precede type 2 diabetes, heart disease, and stroke.

Researchers will study about 1,000 proteins or molecules, called biomarkers, in the blood samples.

"This new agreement takes our research to a whole new level," Dr. Elizabeth G. Nabel, director of the National Heart, Lung, and Blood Institute, said in a statement. "Imagine having a simple blood test to tell us if a patient is at high risk for a heart attack or stroke -- we could do so much more to prevent or delay these often debilitating and deadly diseases."

The Framingham Heart Study is funded by NHBLI and conducted in collaboration with the Boston University School of Public Health. BG Medicine will bring its technology for detecting biological changes to the project.

By Liz Kowalczyk, Globe Staff

State officials gave final approval today to broad regulations banning pharmaceutical and medical device companies from providing gifts to physicians, limiting when companies can pay for doctors' meals, and requiring companies to publicly disclose payments to doctors over $50 for certain types of consulting and speaking engagements.

Drug, biotech and device companies, the hotel and convention industry, doctors and consumer groups had pushed for various changes to the rules, but the final language is close to what staff of the Department of Public Health proposed in December.

There are two substantive changes, however. Companies will have to disclose payments to doctors and hospitals for research designed to promote a particular product, sometimes called "seeding trials''; funding for research aimed at answering a scientific question will still not have to be disclosed.

Also, the department eliminated a provision allowing companies to provide financial assistance for residents and other trainees to attend conferences and education courses.

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By Michele Richinick, Globe Correspondent

State health officials will screen 75 Salem State College students after a male student tested positive for the disease during the past academic year, a school official said.

Salem State mailed letters to the 75 students on Feb. 27 advising them to be screened for tuberculosis, said Karen Cady, a college spokeswoman. Health officials will give free screenings to the specific individuals.

“We looked at the student’s class schedule and ascertained those with whom he could have been with close contact,” she said. “[It was] a precautionary measure.”

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By Stephen Smith, Globe Staff

Cases of influenza in Boston reached a seasonal high last week, with 2.4 percent of all hospital emergency room visits attributed to the viral illness, public health authorities reported today.

Still, this year's flu season continues to be milder than a year ago; during the same period in 2008, nearly 4 percent of ER patients complained of flu symptoms, according to the Boston Public Health Commission.

The flu season has accelerated significantly in recent weeks, with three-fourths of all of this season's flu patients being treated in the past three weeks. A 12-year-old Jamaica Plain boy died from the disease earlier this month.

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By Elizabeth Cooney
Globe Correspondent

Parents, shaken by the death of a 12-year-old Jamaica Plain boy from flu complications, are calling their pediatricians in hopes it is not too late in the season to get their children vaccinated.

The West Roxbury office of Harvard Vanguard Medical Medical Associates received 30 calls today, for example, and 15 calls came in to the Children's Hospital Boston primary care center, a high number for this late in February, medical director Dr. Joanne Cox said. Both attributed the uptick in calls to news of the first death of a child from flu this winter.

Hunter Pope, a seventh grader at Boston Latin Academy, died over the weekend of influenza complications. Yesterday, public health officials said that the boy had not received the flu vaccine.

Officials were still investigating which strain of flu the boy died from. Laboratory test results on the strain of flu he succumbed to are not yet available. Two types of flu virus -- called A and B -- are responsible for seasonal epidemics.

"Until we get more information on the particular strain of type B this child had, it's impossible right now to say whether the vaccine would have protected him, but there have been many persons with type B influenza we know a vaccine would have protected because the type B they got is in the vaccine," Dr. Anita Barry of the Boston Public Health Commission said. "It's the best thing we have at this point and it protects most people."

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A 12-year-old boy has died from complications of the flu, Boston school and public health officials confirmed this afternoon.

Hunter Pope, a seventh-grader at Boston Latin Academy, died over the weekend, according to a statement from the school system. He is the first Massachusetts child known to have died of the flu this year.

Dr. Anita Barry, director of the infectious disease bureau for the Boston Public Health Commission, said the death was still being investigated, but at this point there was no evidence that the boy had serious health conditions or was suffering from another infection that would heighten his risk.

"This is a very rare outcome of influenza infection, but it does happen, unfortunately," she said. "It is rare, but it's a tragedy when it happens."

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Most Americans know about a massive recall of peanut products linked to salmonella cases across the country, but many do not know which foods are involved, a Harvard survey released today reports.

A quarter of people polled earlier this month by the Harvard Opinion Research Program mistakenly believed that national brands of peanut butter are included in the recall of almost 2,000 products, from snack bars to ice cream, that began last month.

The outbreak of salmonella, which has sickened 636 people in 44 states and caused nine deaths, has been traced to a Peanut Corporation of America plant in Georgia. Peanuts from the plant were used in only a handful of small-name peanut butter brands, according to the US Food and Drug Administration.

"There’s a striking level of awareness of this recall, and many people have taken action. But they’re not aware of the range of products involved in the recall," Robert J. Blendon of the Harvard School of Public Health said in a statement released with the survey. "People should check the Food and Drug Administration recall list [below] routinely, since the number of products is still growing."

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By Stephen Smith, Globe Staff

Aiming to spare beachgoers from dirty water, state public health authorities proposed today strengthening local government oversight of ocean and inland beaches that can harbor dangerous germs.

The rules would require operators of beaches accessible to the public to get a permit from the local board of health, which would then have the power to shut the beach if it was not operated in a sanitary fashion.

The regulations also make clear that five days before the official opening date of beaches -- for many, that's the Memorial Day weekend -- water must be tested for the presence of bacteria. Signs would have to be prominently posted listing beaches' operating dates, so that beachgoers taking a plunge during other times would know the water was not being regularly sampled for microscopic threats.

"Our effort was to take additional steps to assure that the beaches in the Commonwealth are safe and that the residents are aware of any dangers that may be associated with the beaches," said John Auerbach, the state commissioner of public health.

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By Stephen Smith, Globe Staff

State public health authorities said today that 48 Massachusetts residents have been stricken with the same strain of salmonella that has sickened almost 600 people nationwide. The germ implicated in those illnesses has been traced to tainted peanuts from a Georgia factory.

Patients in Massachusetts have been as young as 1 and as old as 91; all have survived their illnesses. The patient with the most-recent bout of salmonella-related symptoms fell ill Jan. 25, a spokesman for the state Department of Public Health said.

The greatest number of cases has been reported in Middlesex County, with 13. Elsewhere in the state, Barnstable County reported three cases; Bristol, four; Essex, six; Hampden, nine; Norfolk, four; Plymouth, four; Suffolk, one; and Worcester, four.

By Stephen Smith, Globe Staff

A random sampling of pharmacies in Boston's South End and Back Bay neighborhoods this morning showed that the stores had all removed tobacco products as required under a city regulation that went into effect today.

At CVS shops on Tremont and Boylston streets, shelves that once carried cigarettes are now laden with boxes of Nicorette and other nicotine-replacement products designed to help smokers kick the habit. At Walgreens branches in the two neighborhoods, cigarette display cases remained in place -- but with no cigarettes inside.

Small red-and-white signs greeted shoppers entering CVS stores: "Effective February 9, 2009, the Boston Public Health Commission has banned the sale of tobacco products at pharmacies located in Boston. We apologize for any inconvenience resulting from our compliance with this regulation."

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By Stephen Smith, Globe Staff

The flu virus is beginning to move with greater velocity across Massachusetts, public health authorities warned today as they reported that the number of cases stands at its highest level so far this winter.

Based on the findings of a surveillance network of doctors, the incidence of flu cases in Massachusetts during the week ending Jan. 24 reached the "regional activity" level, meaning that cases were seen in some but not all parts of the state.

Two states, Delaware and Virginia, are at the highest level of flu activity, "widespread activity." All New England states, except for Vermont, are experiencing flu at the regional activity level, the next-highest level.

Because the flu season can stretch to April, disease specialists emphasized that it's not too late to get a flu shot, which can provide full protection within two weeks. This year's vaccine, unlike last year's, appears to be a good match with the predominant strain of the virus in circulation.

More information about the flu is available from the Department of Public Health.

The lawyers who won the "Rosie D" case, which sought to compel the state to improve care for low-income mentally ill children, have also won their fight over attorneys' fees.
Federal judge Michael A. Ponsor today ruled that the state must pay the dozen lead plaintiffs' attorneys and staffers on the complex, long-running case a total of just over $7 million. The state, which lost the case in January of 2006, had asked to pay just $2.7 million, arguing that the plaintiffs' attorneys were charging too much and claiming too many hours of work.
In a 24-page ruling, Ponsor noted that in fact, the plaintiffs' attorneys charged less than usual, and for many fewer hours than they could have. The plaintiffs attorneys worked at the private firm of WilmerHale and the public interest firms of the Center for Public Representation and the Mental Health Legal Advisors Committee.
The case was exceptionally complex, Ponsor wrote, and the plaintiffs' victory was "spectacular" and offers a chance "for a far happier life to thousands of disabled children."

By Stephen Smith, Globe Staff

State public-health regulators expressed broad support today for a far-reaching campaign to combat obesity that is championed by the administration of Governor Deval Patrick.

The backing of the Public Health Council appears to ensure that starting in the fall, calorie counts will be posted prominently in major chain restaurants and schoolchildren will receive weight report cards.

The council, an appointed board of physicians, consumer advocates, and academic specialists, is expected to give final approval in a few months to the regulations governing calorie displays and weight report cards. The public will likely get its say during hearings in February.

"It's important that we keep this on the front burner so that people are aware of the problem," said council member Harold Cox, an associate dean at the Boston University School of Public Health.

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State legislators tomorrow plan to revive a bill that would guarantee “fresh air” for patients in psychiatric hospitals. They also plan to expand the measure to give patients recourse if they feel any of their five existing “fundamental rights" have been violated.

Last year’s “fresh air bill” would have given inpatients in psychiatric facilities the right to go outside on a daily basis. It was opposed by psychiatric hospitals, which said they could not guarantee patients’ safety and feared staffing problems. It expired in the Senate last session without having been put to a vote.

Advocates for people with mental illness say that access to the outdoors is therapeutic and increasing it would result in shorter and more healing hospital stays for patients. The new bill would also provide patients who believe that their fundamental rights have been violated with a hearing before an impartial officer. Existing law guarantees psychiatric patients such "fundamental" rights as privacy of phone calls, correspondence and meetings with lawyers, but currently, if they feel those rights have been violated, they have little recourse.

By Stephen Smith, Globe Staff

More than 60 adults and children across New England have fallen ill with the bacterial disease salmonella since September, part of a mysterious national outbreak that has stricken hundreds of people.

In Massachusetts alone, 39 people ranging in age from infancy to their 90s have developed the telltale symptoms of the infection, including diarrhea, fever, and abdominal cramps. Connecticut, Maine, New Hampshire, Rhode Island, and Vermont are all reporting cases, too, according to representatives of health agencies in those states. All of the patients have survived.

Like nearly 400 people across the nation, all of the New England patients carry a distinctive strain of the germ, suggesting they were exposed by the same source. Disease sleuths have yet to figure out where the bacteria originated, although a spokeswoman for the US Centers for Disease Control and Prevention said investigators assume the cause is tainted food.

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By Carey Goldberg, Globe Staff

The state Department of Mental Health, facing a more than $9 million cut in its budget, today began laying off nearly one-quarter of the case managers who supervise people with severe mental illness and make sure they get the services they need.

About 100 case managers received their pink slips today or will get them tomorrow, said John Labaki, president of the Department of Mental Health chapter of local 509 of the Service Employees International Union, which represents state case managers, clinical social workers, and others.

The state estimates that more than 3,000 clients are losing their case managers, and a department spokeswoman said these clients will be shifted to other case managers among the remaining 350.

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By Stephen Smith, Globe Staff

Cigar bars and other swank salons devoted to smoking won a significant though temporary reprieve from Boston health regulators today, who decided that the establishments will face extinction in 10 years instead of the five-year grace period originally proposed as part of sweeping new tobacco control rules.

The regulations, approved unanimously by the Boston Public Health Commission, also ban cigarette sales at drugstores and on college campuses in the city and eliminate smoking on the patios of restaurants and bars with outside service. Those restrictions will go into effect in 60 days.

The restrictions give Boston among the most stringent antismoking laws in the United States and place it at the vanguard of widening campaigns to reduce cigarette smoking, especially among young people and the poor.

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By Liz Kowalczyk, Globe Staff

Some members of the state's Public Health Council may be barred from discussing or voting on sweeping new regulations restricting drug makers' interactions with physicians, because they may have their own conflicts of interest.

Public Health Commissioner John Auerbach said during the council's meeting today that his department's staff are interviewing each of the 15 council members to determine whether they have relationships with pharmaceutical or device manufacturers that should limit their participation in the board's deliberations on the proposed rules.

The regulations written by Public Health Department staff are intended to implement a law passed by the Legislature last summer, which bans companies from providing gifts to physicians, limits when companies can pay for doctors' meals, and requires companies to publicly disclose payments to doctors over $50 for certain types of consulting and speaking.

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By Stephen Smith, Globe Staff

One of the nation's biggest healthcare foundations announced today that it is committing $1 million to curb teen violence in Boston by teaching adolescents to forge healthier relationships.

The grant from the Robert Wood Johnson Foundation was awarded to the Boston Public Health Commission for a four-year campaign focusing on violence in Dorchester and Roxbury. The Boston health agency was one of 11 nationwide to receive grants designed to combat teen violence.

"By taking proactive steps to educate our teens about healthy relationships, we are encouraging them to respect not just their peers, but their community in general," Boston Mayor Thomas M. Menino said in a statement.

As part of the initiative, known as "Building Healthy Teen Relationships: Boston," up to 1,500 middle-school students will be taught lessons in the classroom about safer behaviors. And at the Roxbury Multi-Service Center, teen peer mentors will craft a social marketing campaign to address dating abuse.

Another city agency, the Boston Centers for Youth & Families, will also be involved, as well as Children's Hospital Boston.

By Stephen Smith, Globe Staff

Families short on money during tough economic times might be tempted to skimp on healthy eating. But they don't have to, according to a blog called Healthy Food on a Budget that was unveiled today by the Boston Public Health Commission.

To help consumers navigate shrinking budgets, registered dietitian Kathy Cunningham is providing advice that will trim food costs without sacrificing nutritional value. In her first posting, Cunningham writes about Thanksgiving, a holiday that can easily break the food budget. Start checking grocery store flyers now for good deals, she says.

"This week, I found frozen vegetables on sale for $1 per small box at the three major local supermarket chains," Cunningham writes. "Stock up on the variety of vegetables you traditionally serve with your meal, but also think of vegetables that can be added to pot pies or soups when you’re preparing leftovers."

Another tip: use the end pieces of bread loaves in stuffing.

The blog will be updated each week, and consumers can submit questions and post their own recipes and tips. Additionally, the Boston health agency will record podcasts on healthy eating that will also be available at the web site.

By Stephen Smith, Globe Staff

The number of Massachusetts residents dying from overdoses of heroin and other opiates rose nearly 3 percent last year, state health authorities reported this morning.

Preliminary figures showed that opiates killed 645 people in 2007, compared with 628 the year before. While that marked the third rise in overdose deaths in at least three years, the increase was smaller than in previous years. For example, between 2005 and 2006, 19 percent more people succumbed to overdoses.

Department of Public Health authorities attributed the slowing increase in deaths, in part, to expansions in substance abuse treatment and prevention. Those efforts were supposed to expand further, but the nation's economic crisis caused the health agency to trim some new programs, including $5 million the Legislature had appropriated to open 120 beds for treating people who otherwise would be sent to jail for drug offenses.

Earlier this year, the department embarked on a statewide campaign to ensure that drug users have access to a medication called Narcan that can revive users as they spiral into an overdose. Since the program began in January, 170 overdoses have been reversed, according to state figures.

By Stephen Smith, Globe Staff

Leaders of Massachusetts AIDS service organizations were warned this morning to steel themselves for further cuts in spending on HIV treatment, prevention, and education amid deteriorating financial conditions.

Jarrett T. Barrios, a former state senator who now serves as president of the Blue Cross Blue Shield Foundation of Massachusetts, predicted that more reductions in state spending could be just weeks away and that federal cuts may loom, too.

"There will be more cuts in December," Barrios told several dozen people gathered for the annual meeting of the AIDS Action Committee of Massachusetts, the largest private provider of HIV counseling and prevention services in New England. "It is not because this governor wants to make cuts. It is because tax revenues are down."

Last month, the administration of Governor Deval Patrick cut more than $1 billion from the state budget in the wake of the nation's financial crisis. At the Department of Public Health, more than $1.5 million was excised from HIV and AIDS services.

At the federal level, Barrios said reductions may be forthcoming in the Ryan White HIV/AIDS Program, a major provider of dollars to state and local health agencies across the nation.

By Stephen Smith, Globe Staff

A 73-year-old Essex County man bitten repeatedly by mosquitoes while vacationing in northern New England has died from eastern equine encephalitis, state health authorities said today.

The man, whose identity was not released because of patient confidentiality laws, died Sunday, a spokesman for the Massachusetts Department of Public Health said. The man's illness was first made public yesterday, but authorities said they did not become aware of his death until today.

The victim of the viral illness had golfed and camped in Maine and New Hampshire in the weeks before he developed symptoms, which first appeared Sept. 21. He did not spend any time in Massachusetts during that period. The virus typically incubates for 1 to 15 days before causing the dangerous brain swelling that is the hallmark of the disease, which has the highest fatality rate of any mosquito-borne illness.

The man is the first Massachusetts resident to die from eastern equine encephalitis in two years. From 2004 through 2006, 13 Massachusetts residents contracted the virus, resulting in six deaths.

With the arrival of cooler autumn weather, the threat of mosquito-borne illnesses such as eastern equine encephalitis and West Nile virus has significantly subsided in Massachusetts, and in parts of northern New England where hard frosts have already descended, there is no longer any danger of being exposed to the virus.

By Bina Venkataraman, Globe Correspondent

About 10 people spoke during a Boston Public Health Commission hearing this morning on its proposed rule to ban cigarette sales at the city’s pharmacies and college campuses. The rule would also ban smoking on outdoor patios of restaurants, and, in five years, ban smoking in hookah bars and cigar bars.

Representatives of a Back Bay cigar bar urged that they be exempted from the ban, while public health specialists endorsed the proposed restrictions.

“The sale of cigarettes in pharmacies is very rare outside the United States,” said Andrew Seidenberg of the Harvard School of Public Health in his testimony.

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Family income and a mother's education are strongly linked to the health of children across the country, but in some states the gap between haves and have-nots is wider than others.

Massachusetts has the second-smallest difference in infant mortality rates when the chances of highly educated women's babies living past their first birthdays were compared to all babies in the state, according to a report released today from the Robert Wood Johnson Foundation's Commission to Build a Healthier America. Maine has the smallest gap.

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By Patrica Wen, Globe Staff

More than 200 bags of White Rabbit Creamy Candies have been confiscated from five Asian food markets in Boston, in response to government reports that these imports from China may have been tainted with melamine.

In a telephone interview this morning, Thomas Goodfellow, assistant commissioner of the Boston Inspectional Services Department, said four of the five markets involved were located in Boston's Chinatown, and the other was in Dorchester. He said the candy bags were removed on Sept. 25th, and they are being shipped back to the distributor.

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By Stephen Smith, Globe Staff

Mosquitoes infected with eastern equine encephalitis have been found in New Bedford and Raynham, the eighth time this year insects carrying the highly lethal virus have been discovered in southeastern Massachusetts, state health authorities reported this afternoon.

No human cases of eastern equine encephalitis have been reported in Massachusetts since 2006.

Heavy rains in recent weeks have contributed to a flourishing mosquito population, state disease trackers said.

To avoid being bitten, public health authorities recommend that people avoid being outside from dusk to dawn, peak time for mosquito activity. If outdoor activity is necessary during those hours, long-sleeved shirts, long pants, and socks can provide protection. Repellants can help, too, including DEET, permethrin, picaridin, or oil of lemon eucalyptus. DEET should not be used on babies younger than 2 months and should be used in concentrations of 30 percent or less on older children. Oil of lemon eucalyptus should not be used on children under the age of 3 years.

Draining standing water from gutters, unused flower pots, and wading pools can deprive mosquitoes of necessary breeding grounds. And having secure window screens can prevent the bugs from getting inside homes.

By Stephen Smith, Globe Staff

Boston health authorities have added a second time when the public can have its say on the city's effort to eliminate cigarette sales at drug stores and on college campuses, a measure that would also extend smoking bans in restaurants and bars to their outdoor patios.

A public hearing is now planned from 10 to 11 a.m. Oct. 8, in addition to the originally scheduled hearing from 5 to 7 that evening. The morning session was scheduled to accommodate people who will observe the Jewish holiday of Yom Kippur starting at sundown that evening.

Both hearings will be in the city's Carter Auditorium at the Northampton Square complex, 35 Northampton St.

The Boston Public Health Commission is also soliciting written comments on the rules, which received preliminary approval last week. They may be sent by e-mail to boardofhealth@bphc.org or by postal mail to Boston Public Health Commission, Board Office, Attention: Julie Webster, 1010 Massachusetts Ave., Sixth Floor, Boston, 02118. The comments are due by Nov. 3.

The regulations would be some of the strictest in the nation and would also significantly increase fines for selling tobacco to children and eliminate cigar bars within five years.

By Stephen Smith and Martin Finucane, Globe Staff

Massachusetts consumers should avoid infant formula, candy, and other products from China that contain milk and may be contaminated, health authorities said today.

Although there is no proof that tainted products have been sold in the state, authorities are conducting tests to look for evidence of melamine, an industrial contaminant implicated in the deaths of four Chinese babies and the illnesses of 54,000 more who were fed adulterated infant formula.

Inspectors from the Boston Public Health Commission and the state Department of Public Health have visited stores looking for contaminated infant formula but have not found any, authorities said today.

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By Stephen Smith, Globe Staff

The country's largest cigarette maker, Philip Morris USA, sued San Francisco in federal court yesterday, hoping to block that city's pending ban on drug-store tobacco sales.

In a statement, the company described the ban, set to go into effect Tuesday, as "unjust to manufacturers, retailers, and adult consumers because it bars -- without legitimate reason -- certain retailers from offering legal tobacco products to adult consumers who wish to buy them."

Mitch Katz, director of the San Francisco Department of Public Health was seeing patients this afternoon, but in an interview with The San Francisco Chronicle, he said: "Do you remember any part of the Bill of Rights being about pharmacies selling tobacco?" he asked. "Philip Morris has fought every attempt by public health officials to save lives by curbing smoking ... It's a badge of honor for anyone in public health to be sued by Philip Morris."

Boston is also attempting to ban cigarette sales in drug stores, as well as in groceries that have pharmacies. That prohibition is part of sweeping new rules governing the sale and use of tobacco that received preliminary approval earlier this month by the Boston Public Health Commission.

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The oldest public health organization in the country has named a new executive director.

Valerie Bassett will join the Massachusetts Public Health Association, a statewide membership organization founded in 1879 that promotes community, personal, and environmental health. She has been director of policy and research for the Blue Cross Blue Shield of Massachusetts Foundation and is the former director of intergovernmental relations and public health advocacy for the Boston Public Health Commission.

The group's former executive director, Geoffrey Wilkinson, left last year to become senior adviser to Massachusetts Public Health Commissioner John Auerbach.

By Stephen Smith, Globe Staff

Massachusetts health authorities want to enlist schools in one of the most ambitious campaigns in recent public health history: giving influenza vaccine to virtually every child who is 6 months or older.

Earlier this year, federal health regulators said that starting during the 2009-2010 flu season, nearly all youngsters should be vaccinated against the viral infection, which kills an average of 36,000 Americans each year.

John Auerbach, the state's public health commissioner, said today it is unrealistic to think that pediatricians can vaccinate every child in their practice each year given the narrow window of opportunity for administering flu shots and nasal spray. Typically, most vaccine is given from October through December.

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Sudden cardiac arrest outside a hospital is often lethal, but chances for survival can depend on where you live.

A study of 10 North American locations in the Journal of the American Medical Association found that only 4.6 percent of the people whose hearts stopped beating for reasons not related to trauma or terminal illness were revived and kept alive long enough to leave the hospital. Resuscitation isn't always attempted because it's too late or it's against the patient's or family's wishes, but in those cases where resuscitation was attempted, 7.9 percent survived until discharge from the hospital.

The researchers, led by a team from the University of Washington, found a five-fold variation in survival rates among patients who are treated, from 3 percent in Alabama to 16.3 percent in Seattle.

Boston was not included in the study, but Boston EMS tracks the survival of heart patients it treats, and its rate of 13.7 percent places it at the upper end of the range in the study.

"We're probably in the top handful of cities," Dr. Peter Moyer, medical director for the Boston Fire Department, Police Department, and Boston EMS said in an interview.

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By Stephen Smith, Globe Staff

Mosquitoes carrying eastern equine encephalitis were found this week in New Bedford, public health authorities announced today. It is the fifth time this summer that insects infected with the virus have been found in Massachusetts.

Earlier this week, the state reported that mosquitoes with eastern equine, which kills up to 50 percent of people who fall ill with the infection, had been detected in Raynham, which like New Bedford is in the southeast corner of the state. Previously, insects with the virus were discovered in Berkley, Carver, and Halifax.

No human cases of eastern equine encephalitis have been reported in Massachusetts since 2006.

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Massachusetts joined the retail medical clinic revolution in primary care today when the state's first MinuteClinic opened in a CVS store in Medway.

The limited-service clinics, staffed by board-certified nurse practitioners, offer treatment for minor illnesses and vaccinations for common diseases, including flu shots starting next month. The model of care is designed to offer convenient access for patients with sore throats or rashes who may not be able to make an appointment with their primary care doctors, or who may not have a regular healthcare provider. The clinics will be open 8 a.m. to 8 p.m. weekdays and 10 a.m. to 4 p.m. weekends. A visit costs $59.

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By Stephen Smith, Globe Staff

For the fourth time this summer, mosquitoes infected with eastern equine encephalitis have been found in Massachusetts -- this time in Raynham, in the southeastern corner of the state, public health authorities reported today.

Earlier, insects carrying the virus, which kills up to half of people who are infected, were discovered in Berkley, Carver, and Halifax.

No human cases of eastern equine encephalitis have been reported in Massachusetts since 2006.

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By Stephen Smith and Andrew Ryan, Globe Staff

Banned in Boston, starting tomorrow: artery-clogging trans fat, long a staple of french fries, doughnuts, and other food sold in restaurants and corner stores.

The artificial ingredient will be forbidden in 5,600 restaurants and other businesses that make freshly prepared food. It has nothing to do with taste, and everything to do with health, said Barbara Ferrer, who as executive director of the Boston Public Health Commission championed the ban that was approved in March.

"I've become more convinced than ever that what we're doing in Boston is really appropriate," Ferrer said.

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By Stephen Smith, Globe Staff

The public will get its say next month regarding Boston's effort to eliminate cigarette sales at drug stores and on college campuses, a measure that would also extend smoking bans in restaurants and bars to their outdoor patios.

A public hearing will be held Oct. 8, from 5 to 7 p.m., in the city's Carter Auditorium at the Northampton Square complex, 35 Northampton St.

The Boston Public Health Commission is also soliciting written comments on the rules, which received preliminary approval last week. They may be sent by e-mail to boardofhealth@bphc.org or by postal mail to Boston Public Health Commission, Board Office, Attention: Julie Webster, 1010 Massachusetts Ave., Sixth Floor, Boston, MA 02118. The comments are due by Nov. 3.

The regulations would be some of the strictest in the nation and would also significantly increase fines for selling tobacco to children and eliminate cigar bars within five years.

By Elizabeth Cooney, Globe Correspondent

People who go to retail clinics for treatment of simple medical problems often don't have primary care providers to turn to, according to a national study appearing days after Massachusetts approved licenses for its first two drugstore clinics.

The Health Affairs study, conducted by the RAND research organization, is one of the first to compare people who seek medical help at retail clinics with patients of primary care physicians. Retail clinics, including the CVS-owned MinuteClinics that will open next month in Medway and Tewksbury, are staffed by nurse practitioners

Doctors in Massachusetts and across the country have opposed the retail clinics, saying they jeopardize the doctor-patient relationship and further splinter the healthcare system. Public health experts argue that the clinics expand access for people who otherwise might not get appropriate care for their sore throats or ear infections, winding up in emergency rooms when no other option is available.

The RAND researchers, who analyzed 1.35 million retail clinic visits from 2000 to 2007, report that these clinic patients were less likely to have a regular physician than the US population as a whole. They were also more likely to be 18 to 43 years old than patients at primary care offices, according to national data on outpatient care. Most patients were using insurance to pay for their retail clinic visits, the study found. A separate article in Health Affairs says that retail clinic care costs about a third less than care in doctors' offices or urgent care clinics.

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Mosquitoes infected with eastern equine encephalitis have been found in another Southeastern Massachusetts town, state health officials said this afternoon.

Berkley in Bristol County is the latest town in which insects tested positive for the dangerous disease. Last week the state Department of Public Health said infected mosquitoes had been identified in Carver, a town in neighboring Plymouth County.

The state's disease trackers also reported today on another disease transmitted by mosquito bites. West Nile virus-infected mosquitoes were collected in Boston, Clinton, Foxborough, New Bedford, Newton, Northampton, Norton, Wayland, Westport, and Westwood last week. Infected crows were found in Barnstable, Edgartown, East Longmeadow, Longmeadow, Norfolk, North Andover, and Hatfield, and infected blue jays were found in Barnstable, Carlisle, Hampden, Scituate, and Watertown.

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By Neil Munshi, Globe correspondent

More mosquitoes have tested positive for West Nile virus, this time in Hyde Park, according to the Boston Public Health Commission.

While no human cases have been confirmed, this is the seventh case of animal infection in Boston. Infected mosquitoes were found in Dorchester, Jamaica Plain, West Roxbury, and the Boston Harbor Islands. Two weeks ago, a blue jay tested positive for the virus in Charlestown, and last month, a red-tailed hawk in Jamaica Plain.

Last year, six people became ill in Massachusetts, but there were no deaths associated with the virus.

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By Carey Goldberg, Globe staff

All of Massachusetts may soon become a trans fat-free zone.

State Representative Peter Koutoujian, co-chairman of the Legislature's Committee on Public Health, called on state health regulators today to impose a statewide ban on the artery-clogging fat in all restaurant food without waiting for lawmakers' approval.

"It is our responsibility to the residents of the Commonwealth to remove this poison from the food supply," Koutoujian wrote to public health commissioner John Auerbach. Last month, California became the first state to impose a ban.

Auerbach said in an interview today that he enthusiastically supports the idea of a trans fat ban, given convincing findings that the artificial fat contributes to heart disease and other health problems.

The health commissioner said he will look into whether his agency has the regulatory authority to impose such a ban and confer with the local health officials who would enforce it.

"I believe that this kind of a measure would be as significant as the state’s historic ban on smoking in workplaces in terms of its affecting all of the residents of the state," Auerbach said, "and in terms of reducing a contributing factor to a deadly disease."

A new campaign to halt the spread of HIV has enlisted social marketing in Boston to reach people who have the disease -- as well as those who don't.

Called "HIV Stops With Us," the effort pairs one person who is an HIV-positive person with an HIV-negative friend, family member, care provider, or partner. They tell their stories on a web site launched today that invites people to have an online conversation with these "spokesmodels." It also offers links to more information, which for Boston means the state's HIV-AIDS Bureau. Similar programs are also starting in New York City, Buffalo, N.Y., and three California cities, Los
Angeles, Long Beach, and Oakland.

The campaign, which includes advertising in newspapers and on subways and buses, is sponsored in Boston by the Justice Resource Institute and the Massachusetts Asians and Pacific Islanders for Health, with funding
from the Boston Public Health Commission.

By Stephen Smith, Globe staff

For the first time this summer, mosquitoes carrying eastern equine encephalitis have been discovered in Massachusetts, state public health authorities announced this afternoon.

The infected insects were found in Carver. There have been no human cases so far this year in the state. The risk of catching Eastern Equine this summer appears relatively low, in part because the virus is making a late debut in the state. Last year, for example, eastern equine was first detected in early July.

From 2004 through 2006, 13 people contracted the mosquito-borne illness, resulting in six deaths. Eastern equine encephalitis is known to be highly lethal, killing up to half of people who fall ill from the virus.

Disease trackers from the state Department of Public Health also reported today that West Nile virus, another disease spread by mosquitoes, has continued to migrate across the state. During the past week, crows carrying the virus with have been found in Belchertown, Worcester, Hingham, Plymouth, and Barnstable, while infected mosquitoes were identified in Boston, Brookline, Needham, Weymouth, Dedham, Brockton, Dartmouth, Worcester and Medford.

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West Nile virus has gained a foothold in Massachusetts, with "significant activity" in greater Boston, Worcester, and Springfield, state health officials said today.

No human cases have been reported, but infected mosquitoes and birds have been found across the state, the Massachusetts Department of Public Health said today. The latest mosquitoes testing positive for the virus were found in Boston, Needham, and Reading. Infected birds were found in Fall River, Reading, Saugus, Natick, Worcester, and Chicopee.

"We are finding [West Nile virus] throughout Massachusetts. There is significant activity in the greater Boston area; as well as communities in the Worcester and Springfield areas," state epidemiologist Dr. Al DeMaria said in a statement. "People should consider the virus as being established in Massachusetts for the summer. The warm, wet summer is continuing to support mosquito populations and allowing the virus to spread."

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The recall of Whole Foods Market ground beef sold between June 2 and Aug. 6 has shed a new spotlight on Nebraska Beef of Omaha, one of the country's largest meatpackers. Whole Foods has said it did not know that its vendor, Coleman Natural Foods, had used Nebraska Beef to process the meat.

Seven people in Massachusetts, from ages 3 to 60, sickened by E. coli had bought beef from Whole Foods stores in the Bay State, The Boston Globe has reported. The same strain has sickened 31 people in 12 states, the District of Columbia, and Canada, The Washington Post reported today. Whole Foods has asked customers to throw away the beef and bring in packaging or a receipt for a refund.

The Whole Foods ground beef was among 1.2 million pounds of Nebraska Beef recalled on Friday. The processor recalled 5 million pounds produced in May and June after its beef was blamed for another E. coli outbreak in seven states.

Today's Post article (click here for the full report) detailed sanitation violations over the past six years at Nebraska Beef, including these four points:

-- US Department of Agriculture shut down the plant three times in 2002 and 2003 for problems such as feces on carcasses, water dripping off pipes onto meat, paint peeling onto equipment and plugged-up meat wash sinks.

--In 2004 and early 2005, Nebraska Beef was written up at least five times for not removing brains or spinal cords from the food supply, as required. The company corrected the problems. Those parts may be infected with bovine spongiform encephalopathy, or mad cow disease.

--US inspectors in August 2006 threatened to suspend Nebraska Beef operations for not following requirements for controlling E. coli. The company corrected the problem a week later, USDA records show.

--Also in 2006, Minnesota health officials blamed Nebraska Beef for sickening 17 people who ate meatballs at a church potluck in rural Minnesota. Several victims filed lawsuits against Nebraska Beef, including the family of a woman who died.

William M. Lamson Jr., a Nebraska Beef spokesman, told the Post the company and the USDA have increased testing of its meat. It has found no E. coli in products made since July 8.

(Update Sunday evening: A Whole Foods spokesman e-mailed to emphasize that the recall was a "voluntary multi-state recall'' -- not nationwide, but 24 states, the District of Columbia and Canada. A related release said that the states involved were Massachusetts and Pennsylvania and added that the company was "broadening the voluntary recall to the following states out of an abundance of caution'' -- Connecticut, Maine, Rhode Island, Florida, New Jersey, New York, Kentucky, Maryland, Ohio, Pennsylvania, Virginia, Alabama, Georgia, North Carolina, South Carolina, Tennessee, Illinois, Michigan, Minnesota, Missouri, Nebraska, and Wisconsin.)

Massachusetts health authorities are warning consumers not to eat ground beef bought from Whole Foods Markets over the last two months after seven infections have been linked to meat bought there, some after a national recall.

The state Department of Public Health today confirmed the seventh E. coli case linked to ground beef. The people who fell ill -- five of whom were hospitalized -- had all eaten ground beef from Whole Foods last month. Preliminary results indicate that the ground beef products were part of a nationwide recall of meat produced by Nebraska Beef Ltd. because of possible E. coli contamination.

"A review of records from Whole Foods indicates that some of the stores received product from the recall list," the state said in a release. "At this time, it is not known why the food listed under the USDA recall was sold to the public after the recall date."

In a statement, Whole Foods said it will "continue to work with state and federal authorities as this investigation progresses, and looks forward to providing its customers with the high quality products that they have come to expect."

The products involved include ground beef and ground beef patties from the stores' meat counters as well as packaged meat found in the stores' cooler. Any meat bought between June 2 and August 6 should be thrown out, state officials said. Consumers should also check their freezers for meat they may have bought last month and frozen for later use.

E. coli can cause bloody diarrhea, dehydration, and in the most severe cases, kidney failure. The very young, the elderly and persons with weakened immune systems are the most susceptible to foodborne illness.

Ground beef cooked to an internal temperature of 160 degrees Fahrenheit kills the bacteria.

Drug-resistant tuberculosis comes in two forms: bad and worse. New research from Harvard shows progress against the worst kind.

People with multidrug-resistant tuberculosis can't be helped by two first-line drugs, cutting down their chances of being cured. People whose disease does not respond to those two first-line drugs or to three classes of second-line drugs have what is called extensively drug-resistant tuberculosis, or XDR TB. Their chances of cure are even lower. First reported in 2006, the XDR TB strain has been found in 49 countries.

Writing in the New England Journal of Medicine, researchers from Harvard, working with colleagues in Peru, report good news in the battle against XDR TB. Their retrospective study found that an aggressive, comprehensive treatment program tailored to individual patients cured more than 60 percent of patients whose previous therapy had failed.

“It’s essential that the world know that XDR-TB is not a death sentence,” lead author Carole D. Mitnick of Harvard Medical School said in a statement.

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Mosquitoes are flourishing in this year's rainy season, spreading West Nile virus across Massachusetts, state health experts said this afternoon.

West Nile virus-infected mosquitoes have been trapped in Merrimac, Abington, Worcester, Springfield, Chicopee, Fall River, Somerset, and Dedham, according to the state Department of Public Health. A blue jay in Boston has tested positive for the virus, the second bird with the illness in the city among 10 across the state this summer. No human cases have been reported.

"People should consider the virus as being established in these areas for the summer," state epidemiologist Dr. Al DeMaria said in a statement. "We are continuing to find virus in new areas; the warm, wet summer is continuing to support mosquito populations and allowing the virus to spread.”

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Smoking bans that protect people from secondhand smoke in public spaces or at work don't do much for the most vulnerable population: children at home or in the family car.

To encourage parents to quit, Massachusetts General Hospital wants
pediatricians to deliver an anti-smoking message to parents during a child's regular checkups.

Dr. Jonathan P. Winickoff and his colleagues in the Clinical Effort Against Secondhand Smoke Exposure, or CEASE, explain how they came up with the plan in the current Journal of Pediatrics. They tested the program among eight pediatric practices in the Boston area and presented it at national meetings.

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By Stephen Smith, Globe staff

For the first time this summer, mosquitoes infected with West Nile virus have been discovered in Boston, public health authorities announced today.

The disease-carrying insects were found in West Roxbury; last week, a red-tailed hawk infected with the virus was discovered in Jamaica Plain.

No human cases of West Nile have been reported in Massachusetts this year; last year, six people fell ill with the disease.

Boston authorities have already started putting insecticide in catch basins to reduce the number of mosquitoes.

Earlier this month, mosquitoes carrying West Nile were discovered in Brookline and Worcester.

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By Stephen Smith, Globe staff

The percentage of adults smoking in Massachusetts reached a historic low in 2007, with one in six Bay State residents reporting that they regularly use cigarettes, according to a state study released this afternoon.

Massachusetts now has the fourth-lowest rate of smoking in the nation, eclipsed only by California, Utah, and Connecticut.

"This is great news for Massachusetts," said Dr. JudyAnn Bigby, the state's secretary of health and human services, in a statement. "The decline in smoking shows that our investment in tobacco control and prevention activities is paying dividends."

Two decades ago, nearly 28 percent of Massachusetts adults regularly smoked. By 2007, that number had fallen to 16.4 percent.

The percentage of adults smoking declined by nearly 8 percent in a single year, with the drop from 2006 marking the steepest year-to-year decrease in a decade. In 2007, the state Department of Public Health resurrected its widely heralded series of in-your-face television commercials designed to persuade smokers to quit.

State health authorities also announced today that they are extending a nicotine replacement patch giveaway through Aug. 31 because of significant demand. The initiative provides Massachusetts smokers with a free two-week supply of patches. The patches are available through the state's Quitline, at 800-879-8678. That hot line is open 9 a.m. to 9 p.m. weekdays and 10 a.m. to 6 p.m. weekends, with help available in English and Spanish.

Further information about stopping smoking is available at www.makesmokinghistory.org.

An internationally renowned and respected health leader will become head of the Harvard School of Public Health, the university said today.

Dr. Julio Frenk (left), former minister of health of Mexico, will become dean of Harvard's faculty of public health in January, succeeding Barry Bloom, Harvard President Drew Faust said in an e-mail to the public health school staff.

In 2006, Frenk was a finalist to lead the World Health Organization, where he had previously been a senior official. He also worked for the Bill & Melinda Gates Foundation, and the University of Washington's Institute for Health Metrics and Evaluation after founding the National Institute of Public Health in Mexico.

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By Stephen Smith, Globe staff

For the first time this summer, West Nile virus has been detected in Boston, public health authorities announced this afternoon.

A red-tailed hawk infected with the disease was found in Jamaica Plain, the Boston Public Health Commission said today. The virus is usually spread by mosquitoes.

No human cases of West Nile have been reported in Massachusetts this year; last year, six people fell ill with the disease.

Boston authorities have already started putting insecticide in catch basins to reduce the number of mosquitoes.

Earlier this month, mosquitoes carrying West Nile were discovered in Brookline and Worcester.

To avoid being bitten, public health authorities recommend staying inside from dusk to dawn, peak time for mosquito activity. If outdoor activity is necessary during those hours, long-sleeved shirts, long pants, and socks can provide protection.

Repellants can help, too, including DEET, permethrin, picaridin, or oil of lemon eucalyptus. DEET should not be used on babies younger than 2 months and should be used in concentrations of 30 percent or less on older children. Oil of lemon eucalyptus should not be used on children under the age of 3.

Draining standing water from gutters, unused flower pots, and wading pools can deprive mosquitoes of necessary breeding grounds. And having secure window screens can prevent the bugs from getting inside homes.

Massachusetts health experts said they haven't seen any of the worry that prompted federal health officials yesterday to reassure the public about the safety of a vaccine that protects girls and young women from a virus that causes cervical cancer.

It's the the vaccine's cost, triple doses and customary caution from parents that initially slowed down the innoculation rate, state officials said, not any unusual level of concern.

The Food and Drug Administration and the US Centers for Disease Control and Prevention said yesterday they have been monitoring reports of possible side effects from Gardasil, but did not find evidence to support a link between serious problems and the vaccine.

Approved two years ago, the vaccine is recommended for ages 9 through 26. The idea is to immunize girls and women against the human papillomavirus, which is spread through sexual activity, before they become exposed.

Dr. Carole Allen (left), director of pediatrics for Harvard Vanguard Medical Associates, said the parents and patients she sees in her Somerville practice weren't asking about the vaccine's safety but showed some reluctance when she first suggested it. But when they returned a year later for the next checkup, they said yes.

"Some parents were saying, Is this going to make my child feel like they have to have sex now?" she said in an interview. "I always presented it from the point of prevention. You do it before you need it -- that's the whole point."

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By Stephen Smith, Globe Staff

An elderly patient on Cape Cod has tested positive for a rare brain disease called Creutzfeldt-Jakob disease, state public health officials announced this afternoon.

Each year in Massachusetts, six or seven people are diagnosed with the degenerative disorder, which in most cases leads to rapid death.

The disease, known for decades among neurologists, first came to widespread public attention during the mad cow scare of the 1980s, when cases of the disorder were linked to tainted beef in the United Kingdom. But only three such cases have ever been identified in the United States, and all of those were in patients who had come from Great Britain.

Further tests will be conducted to determine the cause of the Cape patient's illness, but state disease trackers said there is nothing to suggest that the patient's case is associated with mad cow disease. Instead, like virtually all cases in the United States, it is almost certainly not linked to any obvious external cause.

By Stephen Smith, Globe Staff

For the second time in a week, mosquitoes infected with West Nile virus have been detected in Brookline, public health authorities said today.

The bugs were collected Friday from the same site where West Nile had been discovered earlier. Authorities are not disclosing the exact location, saying they do not want traps disturbed.

Mosquitoes carrying West Nile have also been found in Worcester.

No human cases of the potentially lethal illness have been reported so far this year in Massachusetts. Last year, six people fell ill with the illness, which usually spreads to people through the bite of an infected mosquito.

To avoid being bitten, public health authorities recommend avoid being outside from dusk to dawn, peak time for mosquito activity. If outdoor activity is necessary during those hours, long-sleeved shirts, long pants, and socks can provide protection. Repellants can help, too, including DEET, permethrin, picaridin, or oil of lemon eucalyptus. DEET should not be used on babies younger than 2 months and should be used in concentrations of 30 percent or less on older children. Oil of lemon eucalyptus should not be used on children under the age of 3 years.

Draining standing water from gutters, unused flower pots, and wading pools can deprive mosquitoes of necessary breeding grounds. And having secure window screens can prevent the bugs from getting inside homes.

By Stephen Smith, Globe Staff

The National Institutes of Health will present a live webcast tomorrow of a blue ribbon panel's ongoing review of a controversial laboratory being built by Boston University.

The meeting, which will be at the NIH headquarters in Bethesda, Md., will be aired on-line starting at 8 a.m. at videocast.nih.gov.

The session is scheduled to focus on how BU and NIH can forge partnerships with the community surrounding the South End project. The executive director of the Boston Public Health Commission, Barbara Ferrer, is scheduled to speak as well as Klare Allen, the activist who has led opposition to the lab for five years.

The blue-ribbon panel was convened by NIH after the National Research Council, an independent board of scientists, issued a report in November that was sharply critical of the federal government's earlier safety reviews of the BU project.

The lab, largely underwritten by NIH, is designed to allow researchers to work with the world's deadliest germs, including Ebola, plague, and Marburg. More than 80 percent complete, the project is on Albany Street amid the university's medical school campus.

By Stephen Smith, Globe staff

Mosquitoes infected with West Nile virus have been detected in Brookline, the second time this summer that bugs carrying the potentially lethal disease have been identified in Massachusetts, public health authorities reported today.

No human cases of the disease have been reported so far this summer. Last year, six people were stricken with West Nile.

The infected mosquitoes were collected Tuesday in Brookline. Mosquitoes carrying West Nile were earlier found in Worcester.

To avoid being bitten, public health authorities recommend avoid being outside from dusk to dawn, peak time for mosquito activity. If outdoor activity is necessary during those hours, long-sleeved shirts, long pants, and socks can provide protection. Repellants can help, too, including DEET, permethrin, picaridin, or oil of lemon eucalyptus. DEET should not be used on babies younger than 2 months and should be used in concentrations of 30 percent or less on older children. Oil of lemon eucalyptus should not be used on children under the age of 3 years.

Draining standing water from gutters, unused flower pots, and wading pools can deprive mosquitoes of necessary breeding grounds. And having secure window screens can prevent the bugs from getting inside homes.

By Stephen Smith, Globe staff

Massachusetts health regulators launched a major campaign today to catch prescription drug abusers by alerting physicians when patients go "doctor shopping" in pursuit of potent pain-killers and stimulants.

The practice of visiting multiple clinics and pharmacies to have prescriptions filled has drawn increasing scrutiny. Substance abuse specialists and regulators said they are concerned that prescription-medication abuse now rivals heroin and other street drugs as a health threat.

Between 1996 and 2007, the number of people believed to be engaging in doctor shopping in Massachusetts soared 170 percent, to more than 2,900 last year, according to state records.

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By Stephen Smith, Globe Staff

The state Public Health Council voted unanimously today to make it harder for Boston's teaching hospitals to extend their reach into the suburbs, where community hospitals feel under siege by their powerful rivals.

Members of the panel said that rules drafted by the Patrick administration hold the promise of making health planning in the state more rational.

"I do believe it is an unequal playing field now, and we're driving healthcare to more and more expensive environments," said Dr. Alan Woodward, a member of the council, which sets health policy in the state.

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By Stephen Smith, Globe staff

Massachusetts health authorities this evening are blaming five additional cases of salmonella on tainted tomatoes, bringing to 17 the total number of illnesses in the state linked to the raw produce.

As with the people whose illnesses were previously identified, the five infections confirmed today appear to stem from eating contaminated tomatoes in late May or early June. So far, a nationwide outbreak of salmonella has sickened more than 600 people.

Federal food regulators have advised consumers to avoid certain raw red plum, raw red Roma, and raw red round tomatoes, and products made from that produce. Authorities have said that it is safe to eat cherry and grape tomatoes, as well as tomatoes sold with the vine attached and those grown at home.

Citing patient confidentiality laws, authorities did not identify the salmonella patients by name, although they said that four are from Suffolk County, including men aged 22, 25, and 29, and a 23-year-old woman. The fifth patient is a 45-year-old woman from Middlesex County. None of their infections is considered life-threatening.

Childhood obesity is too pervasive and pressing a problem to attack with piecemeal approaches, the state's top health official said today, vowing to fuse the best ideas of academic and public policy experts with experiments being played out in cities and towns across Massachusetts.

"It can't be addressed as a health issue alone. We have to think big," John Auerbach, commissioner of the Massachusetts Department of Public Health, told a Massachusetts Health Policy Forum meeting this morning. "We pledge that within a year we will come up with a proposal for a statewide plan that will complement all these activities and knit them together."

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By Stephen Smith, Globe Staff

Massachusetts health officials this afternoon outlined a plan to stop paying doctors and hospitals for services related to their serious medical mistakes, such as surgery on the wrong limb or giving the wrong medication.

In a statement, representatives of four agencies said Massachusetts is the first state in the nation to adopt a policy prohibiting the use of state dollars to reimburse institutions and physicians for error-related care.

The four agencies -- the Office of Medicaid, also known as MassHealth; the Group Insurance Commission; the Commonwealth Health Insurance Connector Authority; and the Department of Correction -- directly insure or pay for care for more than 1.6 million people in Massachusetts.

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Cigarette sales have been declining at a steady clip in recent years, but cheaper forms of tobacco have become more popular at the same time, Harvard scientists report.

In a research letter published in the Journal of the American Medical Association, Gregory N. Connolly and Hillel R. Alpert of the Harvard School of Public Health write that the 3.7 billion-pack, or 18 percent, drop in cigarette sales from 2000 to 2007 may have been offset by an uptick over the same period in sales of small cigars, roll-your-own tobacco, and moist snuff equivalent to 1.1 billion packs of cigarettes, or about 30 percent of the decrease in cigarette sales. Sales of large cigars also grew 37 percent during these eight years.

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By Stephen Smith, Globe Staff

With Cambridge poised to become the third Massachusetts municipality to ban artery-clogging trans fat, the public gets its say tomorrow during a City Hall hearing. The meeting is scheduled from 2:30 to 4 p.m. in the Sullivan Chamber at City Hall, at 795 Massachusetts Ave.

The City Council has endorsed the ban on trans fat in restaurants, and it will become a part of city health regulations July 1. However, health authorities will not begin enforcing the prohibition until a year later, giving chefs time to alter their recipes.

Last year, Brookline became the first Bay State town to adopt a ban on trans fat, which has been linked to heart disease. Boston embraced a similar regulation in January.

The Cambridge ban applies to freshly prepared food in restaurants, not to packaged food with labels indicating the trans fat content.

By Stephen Smith, Globe Staff

State health authorities urged consumers today not to eat soy sprouts produced by Chang Farms in Whatley after discovering that they were tainted with the bacteria listeria. At the same time, the Department of Public Health ordered stores and restaurants to remove the contaminated product.

The sprouts are packaged in 12-ounce plastic bags, labeled under the Chang Farm brand, and have a sell-by date of April 19. The producer issued a voluntary recall.

The Department of Public Health said the sprouts were distributed to stores throughout the state, including Market Basket, Stop & Shop, and Whole Foods.

No reports of illness have been associated with the sprouts. Listeria can cause fever, muscle aches, nausea, and diarrhea.

Consumers with questions can contact the health agency's Food Protection Program at 617-983-6712.

Northeastern University's Bouve College of Health Sciences is launching a master's in public health program in urban health this fall.

Led by Dr. Shan Mohammed, the program is designed to train public-health professionals to reduce gaps in health based on ethnic, racial, and class differences, the university said. The program will examine social, behavioral, and environmental health issues in urban communities. A class of 20 students will work with the Boston Public Health Commission and Northeastern's Center for Community.

By Stephen Smith, Globe Staff

A public hearing on a proposal that could make it harder for hospitals to expand has been scheduled for 10 a.m. May 20, officials said today. The hearing will be on the second floor of the state Department of Public Health's headquarters at 250 Washington St. in Downtown Crossing.

State health regulators unveiled the proposal Wednesday, saying they were concerned about Boston teaching hospitals opening satellite campuses in the suburbs, potentially duplicating services and imperiling community hospitals. Under the proposed rules, hospitals seeking to expand would have to prove that they weren't replicating what exists.

Massachusetts comes in 14th in the nation in federal funding to prevent disease and injury, a health-advocacy organization reports.

Trust for America’s Health calculated how much the US Centers for Disease Control and Prevention spent in fiscal 2007 per person on public health programs in the 50 states. In Massachusetts that came to $25.42 per person, more than the average for the other states in the Northeast, which the study defined as the six New England states plus New York, New Jersey, and Pennsylvania. The South had the highest rate: $29.40 per person.

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By Hinda Mandell, Globe Correspondent

A nurse who was acccused of prescribing thousands of addictive narcotics along with a Needham doctor today agreed to surrender her license and her authorization to work as a nurse practitioner.

The agreement marked the latest development in an investigation of Dr. Joseph Z. Zolot, and his nurse practitioner Lisa Pliner. Both worked at a Needham pain management clinic, the Non-Surgical Orthopedic Center.

The Globe reported in September that Zolot and Pliner ranked 10th and 9th, respectively, on a list of the state's top prescribers of the most addictive narcotics, with only hospitals and other large institutions above them. Together, they wrote nearly 12,000 pain-pill prescriptions in 2006.

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(Pat Greenhouse/Globe Staff/file)

By Stephen Smith, Globe Staff

Boston health regulators today unanimously approved a ban on artery-clogging trans fat in restaurants and grocery stores.

Boston joins a growing number of cities, including New York, Philadelphia and Brookline, in banning the food ingredient, commonly found in french fries, donuts and other fried foods. Trans fat have been linked to heart disease in humans and diabetes in experimental animals.

The first phase of the ban goes into effect in September and will apply to the use of cooking oils, shortening and margarine that contains artificial trans fat. The makers of baked goods will have a year to eliminate trans fat from their products.

Packaged goods clearly labeled as containing trans fat can still be sold. Most major manufacturers have already removed trans fat from their products.

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By Stephen Smith, Globe Staff

Massachusetts health regulators voted unanimously today to ban necklaces, rings, and other childhood trinkets that contain dangerous amounts of lead. The regulation on children's jewelry is believed to be the most stringent in the nation and reflects a desire to protect children from a substance that can cause long-term medical problems.

"Swallowing these jewelry items has caused serious injury and death," said Suzanne Condon, director of the state's Bureau of Environmental Health.

The regulation, approved by the Public Health Council, goes into effect in June and covers lead-containing jewelry sold in stores and through the Internet and catalogues. The sellers of such products will be required to keep on hand detailed information about the contents of the jewelry and to share it with state inspectors. Violators of the ban could face fines from $100 to $500.

For more on lead in toys, see this Globe story.

By Stephen Smith, Globe Staff

State health regulators today proposed a major campaign to catch patients who visit multiple doctors and pharmacies in pursuit of powerful painkillers that can feed addictions.

The practice, known colloquially as "doctor shopping," has drawn increasing attention from substance abuse specialists and regulators who are concerned that prescription medication abuse is as serious a health threat as heroin and other street drugs.

The proposed tracking system, which needs the approval of the Public Health Council, would set off an alarm when a patient appeared to be abusing prescription medications, alerting the doctors who prescribed the drugs.

Paul Dreyer, the Department of Public Health official in charge of the initiative, said in an interview that the campaign is not designed to be punitive but, instead, "to hopefully catch patients who might be drifting into the direction of abuse before they drift too far. It gives physicians an early warning about the behavior of their patients."

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By Stephen Smith, Globe Staff

A 20-year-old student at Fitchburg State College is being treated for bacterial meningitis, a potentially lethal illness, state health authorities said today.

The woman, whose identity was not disclosed because of patient confidentiality laws, was hospitalized over the weekend, said Donna Rheaume, a spokeswoman for the state Department of Public Health. The state had no information immediately available on the student's condition. A letter to students and faculty that was posted on the college's website on Monday said "the student is currently in the hospital receiving treatment."

The college's statement also said that students who may have had close contact with the woman are being treated preventively with antibiotics. Bacterial meningitis, which can cause brain and spinal cord tissue to swell, is spread through kissing or sharing of cups, bottles, knives, forks, or cigarettes.

About 20 to 25 people are diagnosed with bacterial meningitis each year in Massachusetts. State law requires students who live in dormitories to be vaccinated against the disease, or to sign a waiver declining the shot. But the two vaccines available do not protect against every strain of the disease.

By Stephen Smith, Globe Staff

A 6-year-old Suffolk County child has died from influenza, health authorities announced today. The child, who died last weekend, suffered from a number of other health woes, which likely intensified the effects of the viral illness.

Most flu seasons, no more than two youths in the state die from the respiratory infection. The last fatal case of flu in a Massachusetts youth was in March 2006, when a 2-year-old from Boston died. Nationally, about two dozen children have died from the disease this flu season.

Adults and children with chronic medical conditions are most likely to suffer life-threatening complications from the flu. Federal health authorities estimate that each year, 36,000 Americans die from flu or its complications, principally the elderly.

This flu season in New England has been significantly more intense than the previous two years, although authorities from the state Department of Public Health said today that the number of cases peaked the week of Feb. 17 and has eased since then.

By Stephen Smith, Globe staff

CVS Corp. today asked state health authorities to allow it to open medical clinics inside 10 drug stores in Eastern Massachusetts, the first of what are expected to eventually be more than 100 MinuteClinics in the Bay State.

Company executives said they plan to have clinics running by late summer or early fall in Ashland, Beverly, Bridgewater, Danvers, Medford, Medway, Stoughton, Taunton, Tewksbury, and Westford. The company anticipates having 25 to 30 MinuteClinics in Massachusetts before the end of the year, executives said.

The company announced no immediate plans to open clinics inside stores in the city of Boston, but CVS spokeswoman Carolyn Castel said today that "at some point Boston would be in our plans, but I can't be any firmer than that at this stage." Boston Mayor Thomas M. Menino has been a strident foe of the in-store clinics, urging the city's health department to find a way to block their arrival. The mayor has said that the clinics would commercialize the delivery of medical care.

State regulators adopted rules in January that opened the door to in-store clinics in Massachusetts, saying that the facilities would ease the burden on overwhelmed emergency rooms and primary care practices. Tom Lyons, a spokesman for the state Department of Public Health, said he could not commit to a timetable for reviewing the CVS application. "We're going to try to move as quickly as we can but as thoroughly as we can as well, since it's the first time we're going to be acting on these regulations."

By Stephen Smith, Globe staff

Top disease trackers in Massachusetts hailed today's federal recommendation that virtually all US children be vaccinated against influenza, starting in future flu seasons.

If the recommendation is widely implemented, the disease specialists said, it could yield two major benefits: fewer seriously ill children and less transmission of the potentially lethal illness to adults.

"I think it's a great idea because we know that young children are often the first to introduce influenza into a community," said Dr. Anita Barry, director of communicable disease control for the Boston Public Health Commission. An expanding body of scientific research, including landmark studies by scientists at Children's Hospital Boston, shows that when children fall ill with the flu, it often foreshadows more widespread outbreaks among adults.

Specialists at the US Centers for Disease Control and Prevention, which is expected to approve the recommendation from an advisory panel, estimate that 36,000 Americans die annually from the flu. Most of those deaths are among the elderly, but in recent years, doctors and parents alike have become increasingly concerned about the toll exacted by the virus on children. In the fall of 2003, unusual clusters of flu-related deaths were reported among children in Colorado and Texas.

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By Stephen Smith, Globe staff

The percentage of Massachusetts teenagers who smoked cigarettes fell to a 15-year low last year, according to a state report released today.

When asked if they'd smoked in the past month, 17.7 percent of Massachusetts teens in 2007 said they had, researchers from the Department of Public Health found. Just a dozen years earlier, the rate stood at 35.7 percent.

The study also found that high-school students living with smokers were more than twice as likely to become smokers than teens living in families with no smokers.

To help consumers who want the nutritional benefits of eating seafood but worry about the sustainability of fisheries as well as contaminants such as mercury, a national agency has created a web site to answer questions about the most commonly consumed kinds of fish.

The National Ocean and Atmospheric Administration launched FishWatch yesterday at the International Seafood Show now in Boston. The site offers species-specific information on the 50 most commonly fished or farmed seafood types.

A page on seafood and human health presents information on mercury, including advice for pregnant or nursing women, and tips on how to select, store, and prepare fish safely. The information is based on guidelines from the Food and Drug Administration and the Environmental Protection Agency, NOAA said.

By Stephen Smith, Globe staff

State health regulators this morning approved a major crackdown designed to shield patients from catching potentially lethal infections while in the hospital.

The Public Health Council voted unanimously to begin sending state inspectors to hospitals to make sure facilities are following rules meant to reduce the spread of infections to patients. And the panel also approved creating a website that will post the infections rates at every hospital in Massachusetts, starting with the number of infections that happen after knee and hip surgeries.

Hospitals that fail to comply with the rules or that have an excessive number of infections could face the loss of their license, said Public Health Commissioner John Auerbach.

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By Stephen Smith, Globe staff

One out of three infants born in Massachusetts in 2006 were delivered by Caesarean section, the highest proportion ever, according to a state report released today that charts a dramatic rise in surgical deliveries in the past decade.

In 1997, barely 20 percent of Bay State babies were born via C-section, placing the state slightly below the national average. By 2006, the rate had risen to 33.4 percent, a level that now eclipses the national figure.

"I'm concerned about this trend because there is some risk associated with having Caesaran sections in terms of infection and other complications," said Dr. JudyAnn Bigby, the state's secretary of health and human services. "We don't want women to be exposed to these risks unnecessarily."

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By Stephen Smith, Globe staff

Even as he forges ahead with his battle to prevent CVS Corp. from opening in-store clinics, Boston Mayor Thomas M. Menino today quietly convened a summit of high-powered medical players to examine what ails primary care in the city.

The meeting at the city's Parkman House included a who's who from Boston's healthcare landscape, including the presidents of three of the city's biggest hospitals: Elaine Ullian from Boston Medical Center, Dr. Gary Gottlieb from Brigham and Women's, and Ellen Zane from Tufts-New England Medical Center. Leaders of community health centers were there, too, along with the in-coming president of the Massachusetts Medical Society and the dean of Boston University's medical school, Dr. Karen Antman.

"We came together not just to talk about a problem that we all know has existed for some time," Menino said in a written statement after the meeting, "we came together in the spirit of creating a thoughtful and coordinated action plan to reduce barriers that limit access to important medical services."

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A team of Boston investigators has received a federal grant to understand drug-resistant tuberculosis.

Researchers from Harvard, Brigham and Women’s Hospital, and Partners in Health will use a five-year, $14 million grant from the National Institutes of Health to study how multidrug-resistant and extensively drug-resistant strains of TB are developed and transmitted. The basic and drug-resistant forms of tuberculosis combine to kill 2 million people a year worldwide.

Dr. Megan Murray of the Harvard School of Public Health and the Brigham is the principal investigator. She will work with project co-leaders Mercedes Becerra, Partners in Health founder Dr. Paul Farmer, and Dr. Lucila Ohno-Machado, all of Harvard Medical School and the Brigham.

By Stephen Smith, Globe Staff

A state investigation has confirmed that the strain of bacteria that killed three people and sickened two others last year originated on the production line of a mom-and-pop dairy in Shrewsbury.

The germ was found on the floor of the production line at Whittier Farms, state Department of Public Health officials said this morning.

"Finding it in the environment there closes the final loop," said Dr. Alfred DeMaria, the state's director of communicable disease control.

Disease trackers discovered the bacteria during a stem-to-stern review of the Whittier production line conducted after the dairy became the prime suspect in the cases blamed on tainted milk. Investigators found different strains of listeria in a drain, an unwashed bottle, and another piece of equipment at the dairy.

Additionally, further tests of unopened milk collected from Whittier's retail store in Shrewsbury found that seven containers were contaminated with the same strain of listeria that made customers ill.

The dairy has been closed since late December, and state officials said that it will be allowed to reopen only after providing assurances that the facility can safely produce milk.

By Stephen Smith and Tania deLuzuriaga, Globe Staff

Following the lead of New York City and Brookline, health regulators in Boston tonight took the first step toward banning artery-clogging trans fat from French fries, doughnuts, and other food sold in restaurants and corner stores.

The Boston Public Health Commission voted unanimously -- and with little discussion -- to give preliminary approval to a ban that would take effect late this year if it receives another thumbs up in the spring. Commission members were spurred to action by scientific evidence linking artificial trans fat to heart disease in humans and to diabetes and obesity in animal studies. Brookline approved a similar ban last May.

"There is no need to have artificial trans fat," said Anne McHugh, project director of the health department's Boston Steps program, which combats obesity, diabetes, and other chronic diseases. "It's just bad."

In many respects, though, the Boston ban appears to be a regulation in search of a need. New York City prohibited trans fat in the fall of 2006, and in the food business, as goes New York, so goes the rest of the restaurant world.

For large chains such as McDonald's and Starbucks, it made little economic sense to keep using the substance everywhere but New York. For mom-and-pop restaurants in New York and Brookline, an increasing selection of trans fat-free oils and other products made complying with a ban easier than many thought it would be, even if the healthier ingredients sometimes proved more expensive.

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By Stephen Smith, Globe Staff

Boston Mayor Thomas M. Menino today blasted a state decision that paves the way for CVS Corp. and other retailers to open medical clinics inside their stores.

In a statement, the mayor said the decision yesterday by the state Public Health Council "jeopardizes patient safety. Limited service medical clinics run by merchants in for-profits corporations will seriously compromise quality of care and hygiene. Allowing retailers to make money off of sick people is wrong."

Menino called on the city's Public Health Commission, which meets this afternoon, to "look closely at limited service medical clinics and see how we can ensure that all healthcare facilities in Boston offer a comprehensive approach to health and wellness."

Executives of the CVS subsidiary that runs the clinic said they plan to open 25 to 30 MinuteClinics in Greater Boston before the end of the year. The clinics are designed to treat minor illnesses such as sore throats and poison ivy, not chronic diseases or medical emergencies.

Executives from MinuteClinics were not immediately available for comment yesterday.

In a statement responding to Menino's broadside, Department of Public Health officials said: “The members of the Public Health Council were deliberative and thoughtful in their review of the limited service clinic regulation. We believe these types of clinics, operated either as part of a retail operation or in a nonprofit setting can provide the public access to safe, convenient and quality care for minor health issues.”

The death rate for patients undergoing weight-loss surgery in Massachusetts has dropped as the number of the operations has increased, according to a state report released today.

In 2006 there were 3,447 procedures in Massachusetts to reduce stomach size and reroute the digestive tract, up from 200 in 1998 and 14 percent more than in 2004.

The in-hospital mortality rate for weight-loss patients fell from 0.23 percent in 2004 to 0.07 percent in the past two years -- less than 1 death per 1,000 patients -- the state Department of Public Health said today. In 2004, the death rate nationally for the surgery was 0.19 percent; no more recent national number was available.

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By Alice Dembner, Globe staff

John McDonough, the exuberant leader of the advocacy group Health Care for All, plans to step down on Aug. 1, he told his staff and others late yesterday.

After 5 years at the helm, McDonough said he believes it is time for a change for the organization and for himself. McDonough, a former state legislator, said in an interview that he has no immediate plans, but will explore “what I want to do with the rest of my professional career.” He turns 55 in May.

McDonough said he is proudest of the organization’s role as a leader in Massachusetts’s efforts to bring health insurance to everyone in the state. McDonough has overseen a staff of 35 people who have also launched efforts to improve access to dentists for low-income people, address racial and economic disparities in healthcare and improve children’s mental healthcare.

By Stephen Smith, Globe Staff

State public health regulators this morning approved a controversial proposal to allow pharmacies and other retail outlets to open medical clinics in their stores.

The decision by the state Public Health Council sets the stage for CVS Corp. to open 20 to 30 MinuteClinics in Boston-area drugstores during the next year. The in-store clinics are designed to treat the aches and pains of daily life -- strep throat, poison ivy, and ear infections, for example -- not major medical emergencies.

CVS and other advocates of the clinics trumpet their ability to treat minor medical problems quickly and, in the process, deflect some patients from emergency rooms strained by ever-increasing demand. But since CVS first approached the state Department of Public Health last spring, critics have voiced concerns about the quality of care in the clinics, patient privacy, and infection control.

CVS executives said they intend to open 25 to 30 in-store clinics in Massachusetts by the end of this year, and 100 to 150 by 2010.

Eight of the public health council members voted in favor of the clinics, five other members abstained and one was absent.

By Stephen Smith, Globe Staff

An 87-year-old Norfolk County man has died from a bacterial infection linked to tainted milk from a mom-and-pop dairy, the third death related to the outbreak, state health authorities reported this afternoon.

The man, who fell ill in November, died Thursday while hospitalized. Officials at the Department of Public Health declined to identify him, citing patient confidentiality laws.

Two other elderly men died earlier from listeriosis, and all three cases of the bacterial disease have been associated with contaminated milk produced at Whittier Farms in Central Massachusetts.

State disease investigators also reported today that the total number of cases of listeriosis attributed to the milk has risen by one, to five. A 31-year-old Middlesex County woman was diagnosed with the disease in September while in the hospital to deliver a baby, said Dr. Alfred DeMaria, the state's director of communicable disease control. Investigators connected her to the milk after discovering that she had consumed 2 percent and whole milk made by Whittier.

The 31-year-old woman and her baby are both healthy, as is a 34-year-old woman whose illness was previously linked to the outbreak. That woman, though, suffered a miscarriage after exposure to the bacteria.

By Stephen Smith, Globe Staff

The next time the boss tells you to take a hike, don't worry too much. It could be part of a new campaign that Boston Mayor Thomas M. Menino launched today to encourage employers and their workers to stay physically fit during the winter months by taking the stairs.

Menino made his call to hoof it at the Brighton corporate headquarters of shoe company New Balance, one of the first firms to sign on to the initiative designed by the Boston Public Health Commission. Nearly three dozen employers have pledged so far to participate in the "Take the Stairs -- Every Step Counts" campaign.

Those employers promise to post "point of decision" signs urging workers to climb the stairs rather than ride the elevator or escalator. One of the signs proclaims: "No time to exercise today? Your opportunity is now."

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By Stephen Smith, Globe Staff

The state investigation into how milk produced at a mom-and-pop dairy in central Massachusetts became tainted with dangerous germs is increasingly focused on the bottling process, authorities from the Department of Public Health said this afternoon.

The entire production line at Whittier Farms in Shrewsbury is being swabbed by investigators, who are looking for evidence of a bacterium called listeria that has been implicated in the deaths of two elderly men and the illnesses of two other people.

After thoroughly evaluating the dairy's pasteurization practices, investigators concluded that Whittier had followed guidelines regarding the temperature at which milk was sterilized and for how long. That finding pointed state specialists toward the packaging process, when milk is placed in glass or plastic containers, said Suzanne Condon, the top environmental health official at the Department of Public Health.

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By Stephen Smith, Globe Staff

State disease trackers today have received 50 to 100 calls from consumers and their physicians about possible exposure to a bacterial illness from drinking tainted milk. The calls emerged a day after a Central Massachusetts dairy halted production when health authorities implicated it as a potential source of four cases of the disease listeriosis.

In some cases, the callers reported symptoms that they believed were consistent with signs of listeriosis, said Dr. Alfred DeMaria, the state's director of communicable disease control. In other cases, doctors called to get further information about the disease, which strikes about 2,500 people each year in the United States and kills 500.

Patients were told to see their doctors to have their illnesses evaluated, and physicians were told to send blood samples for testing at the state laboratory if patients have suspected cases of listeriosis. Any samples testing positive for the disease, caused by a bacterium called listeria, would then be extensively investigated.

"A lot of people are nervous," DeMaria said.

People concerned about listeria can call the Department of Public Health at 617-983-6800, or visit its website, for information.

By Stephen Smith, Globe Staff

The Central Massachusetts dairy under investigation for its role in four cases of a serious bacterial infection is pledging to cooperate with state disease trackers. Two of the victims, elderly men, died earlier this year after developing a condition called listeriosis.

"We are a family owned and operated business with a reputation for providing fresh farm milk to our customers," Whittier Farms said in a statement. "We strive to produce the best product and therefore we are extremely concerned about the situation and will be working to obtain the results of the investigation. As soon as we receive more information, we will provide further details."

The mom-and-pop farm, which voluntarily halted production yesterday, does not sell its products through major retailers, company officials and major grocers confirmed today. Karen Peirce, a spokeswoman for Shaw's Supermarkets, said none of its stores carry Whittier products.

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By Stephen Smith, Globe Staff

State health authorities tonight urged consumers not to drink milk produced by Whittier Farms in Shrewsbury after an investigation showed it is the likely source of a bacterial illness that killed two elderly men and made two other people sick.

The dairy company agreed to stop production and to alert its customers, who are mainly in the central part of the state. The four people who fell ill with listeriosis all live in Worcester County.

Brand names produced by the company include Whittier, Schultz, Balance Rock, Spring Brook, and Maple, according to state authorities.

Symptoms of the disease include fever, muscle aches, and sometimes nausea or diarrhea. Most people exposed to the bacterium suffer only mild, flu-like symptoms, but the germ can prove deadly to those with underlying medical conditions. Each year in Massachusetts, about 20 to 25 cases of the disease are identified, but that likely represents only a small fraction of the true number.

The state's top disease tracker, Dr. Alfred DeMaria, said in an interview that a milk sample taken today from Whittier Farm tested positive for listeria.

Sophisticated laboratory testing showed that the four people who became ill were infected with identical strains of listeria. The sample taken at the farm will be analyzed to see if it matches the strain in the people.

By Liz Kowalczyk, Globe Staff

The state Public Health Council today delayed a vote until January on whether to allow medical clinics to operate inside retail stores in Massachusetts.

CVS Corp. had asked for numerous waivers from existing regulations so the chain could open 20 to 30 MinuteClinics in Boston-area stores to treat minor illnesses. Instead, to more broadly address the concept of retail clinics, state health officials decided to develop new regulations.

Today, the council asked staff to amend the proposed regulations for a second time to address a number of concerns, including how to ensure that nurse practitioners who staff the clinics are trained to treat children.

Public Health Commissioner John Auerbach said he expects a final vote in January.

"My sense is that people were focused on making concrete recommendations, and if the issues are adequately addressed, people would be inclined to vote favorably," he said.

Massachusetts ranks 33rd in the nation in funding anti-smoking programs, according to a national coalition of public health organizations.

The state will take in $711 million from tobacco settlement funds and tobacco taxes in fiscal 2008, but only $12.8 million -- 1.8 percent -- will go toward fighting tobacco use, according to a report from the Campaign for Tobacco-Free Kids, the American Heart Association, the American Cancer Society, the Cancer Action Network and the American Lung Association.

A state's standing was calculated by comparing money spent in anti-tobacco programs with the amount of money the US Centers for Disease Control and Prevention recommends. CDC set $35.2 million as a minimum funding level for Massachusetts.

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By Stephen Smith, Globe Staff

Five local health departments are banding together this coming weekend to offer free flu vaccinations to adults and children.

Flu shots and a spray version of the vaccine will be given from 10 a.m. to noon Saturday at Arlington Town Hall, 730 Massachusetts Ave. Anyone 6 months and older can receive the shots, while the spray known as FluMist is given only to people between 2 and 49 years old. A record amount of flu vaccine, 2.7 million doses, is expected this year in Massachusetts.

Pneumonia vaccine will also be available for adults 65 and older.

All Massachusetts residents are eligible and no appointment is needed to get a shot at the event, being sponsored by the Arlington, Belmont, Brookline, Newton, and Watertown health departments. For more information, call 781-316-3413.

By Stephen Smith, Globe Staff

The influenza season has dawned in Massachusetts, public health authorities announced today, with 38 cases confirmed so far. Still, that's fewer than at the same time last year, when 63 people had been diagnosed with the respiratory illness.

Disease trackers used the announcement as an opportunity to encourage adults and children to be vaccinated against flu, estimated to cause the hospitalization of 5,000 Massachusetts residents and the deaths of 800. An unprecedented supply of flu vaccine is available this season, with 2.7 million shots in Massachusetts alone. The state government purchased 705,000 of those doses.

Along with the traditional sources of information about where to get a flu vaccination -- physicians and local health departments -- there's also help on-line and from a toll-free service provided by the Massachusetts Department of Public Health, 866-627-7968.

Researchers from Harvard and MIT, working with South African scientists, have decoded the first genome sequence of an extensively drug-resistant tuberculosis strain and have taken the unusual step of immediately posting the data online instead of first submitting them to a journal for publication, they said today.

The team from the Broad Institute of MIT and Harvard, the Harvard School of Public Health, and the University of KwaZulu-Natal are making available the genome sequence of a tuberculosis strain that has been linked to a particularly severe tuberculosis outbreak among patients with HIV in one South African town.

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By Stephen Smith, Globe Staff

For the first time in six years, state tobacco control authorities are returning to the television airwaves with an internationally acclaimed advertising campaign aimed at getting smokers to stop.

The TV ads, part of a broader initiative that includes Internet and transit advertising, were unveiled today and will begin airing tomorrow on cable statewide and on broadcast stations in markets including Boston, Springfield, and Southeastern Massachusetts.

The campaign reprises a wrenching account from a man named Ronaldo Martinez, a smoker who lost his voice to throat cancer. There are new commercials, too, featuring women who recount tobacco-related illnesses they suffered and detail their decision to throw away their cigarettes.

The advertising push, which costs a little more than $1.5 million, is the cornerstone of efforts to reinvigorate the tobacco control bureau in the state Department of Public Health, which had sustained deep budget cuts during the administrations of Jane Swift and Mitt Romney. This year, the Legislature increased spending on tobacco control by $4.5 million, to $12.75 million. Still, that's not even one-fourth of the amount spent when the program was at its peak in 2000.

The state has won a three-year, $500,000 federal grants to help the elderly and people with disabilities or long-term illnesses choose their own care in the community, the Executive Office of Health and Human Services said.

Five agencies will work with individuals and their families to connect with services: the Executive Office of Elder Affairs, the Department of Mental Retardation, the Department of Mental Health, the Massachusetts Rehabilitation Commission and the Massachusetts Commission for the Deaf and Hard of Hearing.

The state will also include more programs serving various cultural and ethnic populations in the Massachusetts Aging and Disability Information Locator.

After seven years of decline, smoking rates across the nation are stuck at about 21 percent, where they have been from 2004 to 2006, federal officials said, a leveling-off possibly linked to greater marketing efforts by tobacco companies and fewer anti-smoking dollars for public health campaigns, the Los Angeles Times and other news outlets say today.

The trend in smoking rates mirrors what has also happened in Massachusetts, according to a story in the Globe in July. Cigarette sales increased after the state dropped its tough anti-smoking ads (like the one at left) in 2001, Stephen Smith reported after the state Legislature voted to reinvigorate the tobacco-control program. Its budget was boosted to $12.75 million for next year, from $8.25 million this year.

A CDC official blamed reduced spending on anti-tobacco campaigns and bigger marketing budgets from cigarette companies for the national numbers.

"What is happening doesn't have to happen," Dr. Matt McKenna, director of the CDC's Office on Smoking and Health, told the LA Times yesterday. "With appropriate support and efforts and counter-marketing, tens of thousands of people don't have to die."

By Stephen Smith, Globe Staff

The state Department of Public Health today issued advice to schools and parents about a potentially dangerous germ that has infected a handful of students in recent weeks.

The bacteria, known as Methicillin-resistant staphylococcus aureus, cannot be treated by first-line antibiotics. However, the germ rarely results in serious, long-lasting health problems, specialists said.

For that information, go to the DPH website.

Massachusetts slipped to ninth place in national health rankings released today, down two spots from last year.

Compiled by the United Health Foundation, the American Public Health Association and the Partnership for Prevention, the report said the overall healthiness of all states has declined by 0.3 percent. The national standings have stagnated since 2000, the report said, after steady improvements from 1990, the survey's first year.

Vermont came in first, followed by Minnesota, Hawaii, New Hampshire and Connecticut in the top five. Mississippi ranks as the least healthy state, along with Louisiana, Arkansas, Oklahomaand Tennessee in the bottom five.

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As toys continue to be recalled for their high levels of lead paint -- including one announced by Mattel Thursday -- the City of Boston is promoting its lead poisoning prevention campaign with an event next month.

A daylong Lead Safe Awareness Resource Fair will highlight the city's home-deleading programs and also test toys for lead. The event will begin at 9:30 a.m. Saturday, Nov. 3, at the First Parish Church, 10 Parish Street, Dorchester.

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State and town officials plan to roll up their sleeves tomorrow to get a flu shot, part of a campaign to promote prevention in a year when more flu vaccine is available than ever before.

Massachusetts Department of Public Health Commissioner John Auerbach, Secretary of Elder Affairs Michael Festa, and Brookline Health Director Alan Balsam will receive their flu shots at 10 a.m. tomorrow at the Brookline Senior Center.

According to the state health department, there are 132 million doses of flu vaccine available in the United States for this winter's flu season, more than in past years. Massachusetts has bought 700,000 doses.

Higher cancer rates among ethnic and racial minority groups cannot be attacked without increasing their representation in clinical trials, community health workers and health care providers heard today.

"The solution is to build community-academic partnerships," Dr. Claudia Baquet, director of the University of Maryland Comprehensive Center for Health Disparities, told about 100 people at a conference at the University of Massachusetts - Boston also sponsored by the Harvard School of Public Health and community outreach organizations. "Notice I said 'community' first."

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By Stephen Smith, Globe Staff

Four adults and one toddler in Massachusetts have fallen ill with salmonella in recent months after eating tainted, frozen pot pies, state health authorities announced today.

All five recovered, but an 82-year-old woman from Bristol County was hospitalized for two days because of complications from the bacterial illness. The other patients who became ill were a 2-year-old boy and a 46-year-old man from Bristol County, a 29-year-old woman from Suffolk County, and a 23-year-old man from Franklin County. Their illnesses happened between May and September.

Tests at the state laboratory in Jamaica Plain showed that the type of salmonella that infected the five Massachusetts victims matches a strain blamed for more than 130 cases of the disease in 30 states. The Massachusetts patients had eaten Banquet brand pot pies that authorities have recalled.

Because of the salmonella contamination, consumers have been told not to eat Banquet pot pies or generic store brands that bear the code or plant number 5009 or P9. Products with that code should be discarded or returned to where they were purchased.

More information is available at the state Department of Public Health's web site, as well as from the US Centers for Disease Control and Prevention. Information is available via telephone from the Department of Public Health's Division of Epidemiology and Immunization at 617-983-6800 or the Food Protection Program at 617-983-6712.

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By Elizabeth Cooney, Globe Correspondent

Sunday’s "brain-eating amoeba" story has been among boston.com’s most e-mailed stories all week, but that’s about as close as the parasite may come to us, state and national health experts said.

Six people have died this year after an amoeba called Naegleria fowleri infected them while swimming in Florida, Texas and Arizona. That’s a spike compared to the 23 deaths from 1995 to 2004, a trend that may continue with rising temperatures, epidemiologist Michael Beach of the US Centers for Disease Control and Prevention said in an interview.

The microscopic parasite, which lives in the bottom of warm, freshwater pools, can crawl into the brain via the olfactory nerve, the pathway from the nose to the brain that is crucial for our sense of smell. Once there, it can cause inflammation that destroys brain tissue. Symptoms typically start with a stiff neck, headache and fever, and death usually follows after three to seven days.

"This is a heat-loving bug that you really find only in hot springs or in southern tier states," Beach said. "We know we tend to see an increase in cases after an extended heat wave, and that's what we think happened this year."

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By Stephen Smith, Globe Staff

A 49-year-old Medford man is hospitalized with West Nile virus, the third person to contract the mosquito-borne illness this year in Massachusetts, state public health authorities reported today.

The man, who was not identified because of patient confidentiality laws, became ill at the end of September.

So far, more than 2,500 cases of West Nile have been confirmed this year in the United States, with most of the infections contracted west of the Mississippi River. In the most severe cases, West Nile virus can cause a high fever, headache, neck stiffness, stupor, coma, tremors, convulsions, muscle weakness, and paralysis. The US Centers for Disease Control and Prevention estimates that one of every 150 people infected with West Nile develops severe symptoms.

Separately, New Hampshire health authorities announced today that they have detected fresh evidence that another disease spread by mosquitoes, Eastern equine encephalitis, is still circulating. Infected mosquitoes were found in four towns, Brentwood, Fremont, Kingston, and Newton.

To avoid contact with infected mosquitoes, the Massachusetts Department of Public Health recommends limiting outdoor activities from dusk to dawn, peak biting times for mosquitoes. Otherwise, wear as much clothing as comfortable and apply insect repellent such as DEET, permethrin, picaridin, or oil of lemon eucalyptus.

DEET should not be used on infants under the age of 2 months and should be used in concentrations of 30 percent or less on older children. Oil of lemon eucalyptus should not be used on children under 3 years old.

By Stephen Smith, Globe Staff

Boston will receive more than $4 million in federal money over the next five years to address gaps in healthcare and to export the advances it has already made to other New England cities, Mayor Thomas M. Menino announced today.

The US Centers for Disease Control and Prevention has designated the city as a Center of Excellence in the Elimination of Disparities, with an emphasis on investigating the health status and medical treatment received by black residents who suffer from cardiovascular disease and breast and cervical cancer. African-American women in Boston are more likely to die from breast cancer than women of any other race or ethnicity.

Two years ago, Menino declared that the most pressing medical issue confronting the city was the persistent gap in health status and treatment that exists among racial and ethnic groups. At that time, the Boston Public Health Commission released a sweeping study on the subject and, later, ordered hospitals to begin collecting detailed information about all patients to better determine why disparities remain.

"We have a pretty good record on this," Menino said in an interview. "But we have to do more."

Talking about the healthcare systems in Canada and the United States has always been a case of compare and contrast, and not just for Michael Moore in "Sicko." A study published today on what patients in Ontario thought about where they received urgent care may be relevant to the current Massachusetts debate on allowing walk-in clinics inside retail stores, but with some caveats.

Like its neighbor to the south, Canada is also suffering from a shortage of primary care physicians. But unlike doctors in the United States, some physicians in Ontario are required by their contracts to provide care after hours, usually until 8 p.m. on weekdays and for a half-day on the weekends. The majority of family practice doctors in the province are moving toward that model, study author Michelle Howard of McMaster University in Hamilton, Ontario, said in an interview.

Even so, some patients still go to independent walk-in clinics or hospital emergency departments for urgent care. A study in today's Annals of Family Medicine surveyed them on which kind of care they liked the best.

Seeing or speaking on the telephone with one's own family physician scored the highest, followed by going to the after-hours clinic affiliated with their doctor. Next came the emergency departement and then a health information telephone service staffed by nurses. Walk-in clinics finished last.

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By Stephen Smith, Globe Staff

A 53-year-old Arlington man and a 48-year-old Worcester woman have been diagnosed with West Nile virus, the first known cases of the mosquito-borne illness contracted in Massachusetts this year, health authorities said today.

Both the man and the woman became sick in August, and both are now at home recovering, said Donna Rheaume, a spokeswoman for the state Department of Public Health.

Three other people were diagnosed earlier in the summer with West Nile while in Massachusetts, but in two cases, the patients were visitors who had been infected in their home state. The third case involved a Boston man exposed to the virus while outside of Massachusetts.

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By Stephen Smith, Globe Staff

A dry summer has yielded at least one benefit: fewer mosquitoes carrying highly lethal Eastern equine encephalitis.

A state health report presented today shows that through Friday, disease trackers had found only 22 pools of mosquitoes carrying the virus. That compares with 121 pools of infected mosquitoes through the same period last year.

Dr. Alfred DeMaria, the state's director of communicable disease control, attributed the decline to the lack of rainfall, which is necessary for mosquitoes to breed robustly. The lack of rain, DeMaria said, has been most pronounced in the southeastern corner of the state, long recognized as a hotbed of Eastern equine activity.

Another mosquito-borne ailment, West Nile virus, appears to be at a level similar to last year, DeMaria said.

Eastern equine is the deadliest of all ailments spread by mosquitoes, killing one-third to one-half of people who contract the illness. No human cases of Eastern equine have been reported in Massachusetts this year.

Three cases of West Nile have been documented in the state, but investigators said they do not believe any of those infections was acquired in Massachusetts. Two of the people with the disease were visiting Massachusetts and appear to have contracted the virus before arriving in the Bay State. Investigators said the third patient, a Boston man, was exposed while in Montana.

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By Stephen Smith, Globe Staff

State health regulators this morning called for a ban on necklaces, bracelets, and other toy jewelry containing dangerously high levels of lead.

Tests performed by the state Department of Public Health found that some of the trinkets, which investigators purchased in stores across Massachusetts, possessed lead levels thousands of times higher than permitted. High lead levels in children have been linked to learning problems and other medical conditions.

State law forbids lead in paint applied to toys and jewelry but neither Massachusetts nor federal regulations cover lead in the metal and plastic contents of toy jewelry, leaving children vulnerable, Suzanne Condon, director of the state's Bureau of Environmental Health, said during a meeting of the state Public Health Council.

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By Stephen Smith, Globe Staff

Making the shift from advocate to official policy maker, the executive director of the Massachusetts Public Health Association announced this week that he is leaving that group to become a senior adviser to Massachusetts Public Health Commissioner John Auerbach.

Geoffrey Wilkinson, who has led the association of state and local public-health officials for more than five years, said in an e-mail that he expects to be involved in helping the state Department of Public Health develop a regional system for public health. Now, the state has separate boards of health in its 351 cities and towns, with widely varying degrees of expertise. Since being named public health commissioner earlier this year by the administration of Governor Deval Patrick, Auerbach has made establishing more centralized regional networks a priority.

Wilkinson, who will earn $87,000 a year, said he will also be involved in strengthening the state's cadre of community health workers.

By Felicia Mello, Globe Correspondent

State health officials said they would consider revising proposed rules to allow the opening of medical clinics in retail stores in response to concerns raised by doctors groups at a public hearing today.

Physicians testified that the regulations did not do enough to prevent infections at the clinics or to ensure that patients receive consistent medical treatment from providers who know their histories. Pediatricians said the clinics should not be allowed to treat children under 2 years old, to avoid confusion with immunization records.

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The Fenway Institute at Fenway Community Health has won a five-year, $1 million government grant to study the health of the lesbian, gay, bisexual and transgendered population.

Researchers will look at the transmission of HIV, characteristics of families and households, and the demographics of health, illness, disability and death among LGBT people. The funding comes from the National Institute of Child Health and Human Development.

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By Stephen Smith, Globe Staff

A 54-year-old Boston man has been diagnosed with West Nile virus, which health authorities said today they believe he contracted while visiting Montana.

The man, who was not identified because of patient confidentiality laws, is recovering, said Donna Rheaume, a spokeswoman for the state Department of Public Health. This is the second human case of West Nile reported in Massachusetts this year.

Last month, a man vacationing on Martha's Vineyard tested positive for the mosquito-borne illness, although disease investigators said he most likely was exposed in Missouri before coming to Massachusetts.

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By Stephen Smith, Globe Staff

Who knew public health could be so hip?

State authorities tomorrow will unveil a glowing, gyrating website called the84.org that's targeted at adolescents, with film clips of antismoking ads made by kids, and an invitation to "peep" or see the winners. It's designed to dissuade youths from smoking -- and to encourage them to quit if they've already started.

The website is part of a broader campaign by the state Department of Public Health that also includes awarding about $200,000 to 18 organizations committed to the fight against teen smoking.

So why call the website the84.org?

"Because 84 percent of teenagers in school don't smoke," said John Auerbach, the state's public health commissioner. "This came from the young people themselves. The impression many young people have is that the majority of teenagers smoke.

"They felt it was important to have a name that suggested the vast majority of young people don't smoke -- that the norm is not smoking."

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Beth Israel Deaconess Medical Center will launch two new fellowship programs in medical microbiology, the hospital said.

Both are designed to teach doctors to understand bacterial agents, parasites and viruses and to run academic, hospital or public health laboratories. The fellows will train at Children's Hospital Boston and the Massachusetts Department of Public Health as well as Beth Israel Deaconess.

By Globe Staff

An 81-year-old man from Missouri may be the first person in Massachusetts to be stricken this year with West Nile Virus, though health officials say he was likely infected in his home state.

The man, whose name was not released, traveled from Missouri to Martha’s Vineyard on Aug. 5 and became ill six days later.

According to the Massachusetts Department of Public Health, the man was most likely exposed to the virus in Missouri, where there have been five reported cases this year. It is possible, however, that he was exposed in Massachusetts.

By Stephen Smith, Globe Staff

A researcher whose work has focused on children's health and healthcare disparities was today named medical director of the Massachusetts Department of Public Health.

Dr. Lauren Smith, a pediatrician by training, will oversee programs regarding early childhood health and also be part of the public health department's team monitoring the quality and cost effectiveness of healthcare reform in the state, according to agency spokeswoman Donna Rheaume. Smith will also lend her medical expertise to issues such as whether the state should allow walk-in clinics in drug stores.

Smith is an associate professor of pediatrics at the Boston University School of Medicine and medical director of the Medical-Legal Partnership for Children at Boston Medical Center, which unites doctors and lawyers to help families meet the basic needs of children. Smith's research has examined how social, economic, and demographic factors influence children's health.

For the past two years, Smith, who received her undergraduate degree from Harvard and her medical and public health degrees from the University of California, has spent the past two years as a health policy fellow in the office of House Speaker Salvatore F. DiMasi.

Smith's position is new. She will be paid $130,000 a year and will begin working part-time immediately and full-time in January.

By Elizabeth Cooney, Globe Correspondent

A leader of the patient safety movement supports Medicare’s decision to not cover hospitals' costs of treating preventable errors, saying it’s time to go beyond altruistic efforts at improving outcomes.

"I would have preferred it to have been positive rather than punitive, but the time has passed for that, I’m afraid," Dr. Lucian Leape of the Harvard School of Public Health said in an interview. "We’ve got a lot of solutions out there and the thing that is so frustrating is they haven’t been implemented."

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Five Boston health workers will finally receive monetary awards stemming from a 2000 discrimination ruling, for what one of the employees said was "being treated like a criminal" when they were laid off 13 years ago.

Today the Supreme Judicial Court ruled that five black women who worked for the Healthy Baby/Healthy Child Program run by the Trustees of Health and Hospitals and the City of Boston were treated differently than a white man who was laid off at the same time.

After a series of appeals and reviews, the payments, with interest dating back to 1994, will more than double the $20,000 to $30,000 each woman originally would have received.

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By Stephen Smith, Globe Staff

For the second time this summer, mosquitoes carrying Eastern equine encephalitis have been detected in Massachusetts. The infected insects were discovered in Seekonk, in far Southeastern Massachusetts.

The earlier batch of mosquitoes carrying the viral ailment was found in Raynham, not far from Seekonk. In past summers, Eastern equine encephalitis has been rampant in the marshy terrain of Southeastern Massachusetts.

No human cases of the disease have been reported this year in the state. Last year, two people died from the disease and three others were infected but survived.

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By Stephen Smith, Globe Staff

For the third time this summer, mosquitoes infected with West Nile virus have been found in Massachusetts, public health authorities announced today. The latest batch of disease-carrying insects was collected in Medford. Earlier, mosquitoes carrying the potentially lethal virus were discovered in Berkley and Marlborough.

Traditionally, West Nile begins circulating widely in mosquitoes in August, increasing the threat of infections in people. No human cases of West Nile have been reported this year in Massachusetts; last year, three people contracted the illness in Massachusetts; all survived.

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By Stephen Smith, Globe Staff

For the first time this summer, mosquitoes infected with West Nile virus have been found in Massachusetts. The virus-carrying insects were found in Berkley, in Southeastern Massachusetts, state health authorities announced today.

The mosquitoes were collected Thursday as a part of routine sampling conducted each summer and fall. A bluejay infected with West Nile was found last week in Marlborough, in the MetroWest region.

No human cases of the mosquito-borne disease have been reported this year in the state. Last year, three people contracted the illness in Massachusetts; all survived.

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JudyAnn Bigby, state secretary of Health and Human Services, today named new commissioners of the Department of Mental Health and the Massachusetts Commission for the Blind and a new director of Medicaid.

Barbara Leadholm will return to the mental health agency after 10 years in the private sector as a vice president at Magellan Health Services, a company that manages behavioral health care for large health plans. At the Department of Mental Health, she was assistant commissioner for policy and planning from 1990 to 1993 and then Metro South Area director until 1996.

In a joint interview, Bigby and Leadholm sounded the same theme of integrating services for medical and behavioral health – a term Leadholm said she prefers to "mental health" because it includes problems such as substance abuse. They also said distinctions between private and public insurance are not as important as building a coherent system of care.

"Barbara’s background brings a special combination of experience that will serve us and the Department of Mental Health well as we look at strategies for optimizing services and ensuring quality, looking at the type of outcomes that we want to see that really focus on the individual, not just on mental illness," Bigby said. "We want to ensure that we have a unified set of standards and principles."

Leadholm had previously worked at the former Department of Welfare as director of chronic and specialty hospitals, director of CommonHealth and special populations, and provider manager for mental health and mental retardation. She holds a master's degree in psychiatric nursing from Boston College and an MBA from Boston University.

"I’ve got about 30 years of experience working both in the public sector as well as the private sector. That allows me to have a broad perspective," Leadholm said. "We want to look at how we can work together to make sure the system makes sense for more people. It’s very confusing for anyone who has a child with a serious emotional issue or a family facing schizophrenia for the first time. I don’t think it matters whether you have private insurance or whether you look to the state for assistance."

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By Stephen Smith, Globe Staff

For the first time this summer, a bird carrying West Nile virus has been found in Massachusetts. The infected blue jay was detected in Marlborough and tested positive yesterday.

No human cases of the mosquito-borne disease have been reported this year in the state. Last year, three people contracted the illness in Massachusetts; all survived.

So far this year, most human cases of the disease have been reported west of the Mississippi River, with California reporting 27 cases, the most in the nation.

In the most severe cases, the infection can cause a high fever, headache, neck stiffness, stupor, coma, tremors, convulsions, muscle weakness, and paralysis. The US Centers for Disease Control and Prevention estimates that one of every 150 people infected with West Nile develops severe symptoms.

To avoid contact with infected mosquitoes, the Massachusetts Department of Public Health recommends limiting outdoor activities from dusk to dawn, peak biting times for mosquitoes. Otherwise, wear as much clothing as comfortable and apply insect repellent such as DEET, permethrin, picaridin, or oil of lemon eucalyptus.

DEET should not be used on infants under the age of 2 months and should be used in concentrations of 30 percent or less on older children. Oil of lemon eucalyptus should not be used on children under 3 years old.

By Stephen Smith, Globe Staff

Massachusetts health authorities today advised consumers to discard any recalled products made by Castleberry's Food Co., even if the canned products look and smell safe.

Four people in Indiana and Texas fell ill with botulism after eating Castleberry's Hot Dog Chili Sauce; no botulism cases have been reported in Massachusetts.

The company is recalling a long list of products, sold under a variety of brand names, including chili with and without beans, beef stew, corned beef hash, and barbecue beef. Some dog food made by the company is also being recalled. For a full list of the recalled products, go to http://www.castleberrys.com/news_productrecall.asp.

Products found on Massachusetts store shelves are being removed and destroyed, the state Department of Public Health said.

By Liz Kowalczyk, Globe Staff

State public health officials are moving to allow medical clinics to open in retail stores, but are delaying a decision on whether to let CVS Corp. open 20 to 30 "MinuteClinics" in the Boston area.

The state announced today that it will propose new regulations by Aug. 8 to permit the operation of "limited scope" medical clinics. But the plan postpones the Department of Public Health's decision about whether to allow CVS to open primary care clinics in its pharmacies, beginning in Weymouth. CVS had hoped to open its first clinics this fall, but the start date could be delayed because the company will have to reapply under the new regulations.

The company indicated in a statement today that it would reapply.

Still, the announcement indicates that Massachusetts health officials are open to allowing retail medical clinics -- and other types of smaller clinics run by community health centers or hospitals -- to help ease emergency room overcrowding, provide better access to basic medical care, and as a convenience to consumers.

"What we believe is that there is enough evidence that the provision of limited clinical services in what might be called non-traditional settings has benefit that is worthy of consideration," said public health commissioner John Auerbach.

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The number of people dying of cancer has fallen slightly in Massachusetts while the number of newly diagnosed cases has stayed about the same. But racial and ethnic disparities remain, in both the risk of developing cancer and dying from it, a new state report says.

The change in mortality rates was small but significant, according to the state Department of Public Health’s latest study, which covers 2000 through 2004.

In 2000, the mortality rate from 24 types of cancer was 205.8 deaths per 100,000 people. In 2004 it declined to 187.9 deaths per 100,000 people. The incidence of new cases declined each year, but the decrease was not statistically significant.

"The report shows that progress is being made. When we focus on prevention, as in reducing tobacco use, or focus on screening for early identification and treatment, we can save lives," DPH Commissioner John Auerbach said in an interview today. "On the other hand, cancer remains the second leading cause of death in Massachusetts and many people are still engaged in behaviors that put them at risk."

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By Stephen Smith, Globe Staff

A statewide ban on artery-clogging trans fat lost its biggest potential roadblock today when the leading association of restaurateurs told legislators it will not fight the measure.

Massachusetts would become the first state to order restaurants to remove trans fat, a staple of frying oils and baked goods that has been linked to heart disease in humans and to diabetes and obesity in animal studies.

New York City approved a similar ban last year, a move that has inspired campaigns across the nation to consider similar regulations. The ban took effect last week amid little complaint.

A prohibition here would represent one of the most sweeping public-health initiatives in the state since smoking was banned from restaurants and bars in 2004. The tobacco rule faced ferocious opposition for more than a decade, most notably from the 5,500-member Massachusetts Restaurant Association, which argued initially that it would hurt business.

But today, Restaurant Association President Peter G. Christie told lawmakers that a statewide trans-fat ban would be preferable to a patchwork of local regulations. In May, Brookline became the first town in Massachusetts to embrace a trans-fat ban, although restaurants have until November of next year to comply. Boston and Cambridge have also considered bans.

"If it's decided that we need to take these things out of our foods in restaurants for health interests, we'll be willing to work with you," Christie told the Legislature's Joint Committee on Public Health.

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By Stephen Smith, Globe Staff

For the first time this summer, mosquitoes infected with Eastern equine encephalitis have been detected in Massachusetts.

The state Department of Public Health announced today that the disease-carrying insects were found Wednesday in Raynham, in Bristol County. No human cases of the viral illness have been reported so far this summer.

Last year, five people contracted Eastern equine encephalitis, two of whom died.

The virus kills one-third of its victims and half of those who survive suffer permanent neurological damage. There is no cure; survivors often require lengthy hospitalization.

The department has put together videos about the dangers of EEE and ways to prevent it.

By Stephen Smith, Globe Staff

Massachusetts public-health authorities announced today that they have discovered tubes of toothpaste that may contain a dangerous chemical on store shelves in Boston and 11 other cities and towns.

The discovery comes as federal regulators report that some toothpaste made in China and elsewhere abroad contains diethylene glycol, a substance used in antifreeze. Long-term exposure to the chemical can cause kidney and liver problems.

The state Department of Public Health urged consumers not to use toothpaste falling into these categories:
-- If it is labeled "Made in China." The US Food and Drug Administration has identified a variety of brands made in China, including Cooldent, Dr. Cool, Everfresh Toothpaste, Superdent, and Oral Bright.
-- If is labeled as "Colgate" that is made in South Africa. Colgate officials have said their company does not import toothpaste from South Africa. The warning from health authorities does not apply to Colgate toothpaste made in the United States.
-- If the labeling is not in English.

Investigators from local health departments found about 160 tubes of toothpaste fitting those descriptions in shops in Amherst, Arlington, Boston, Cambridge, Dedham, Lawrence, Lowell, Malden, Somerville, Sturbridge, Wellesley, and West Springfield. It is not known whether any of the tubes contains diethylene glycol, a spokesman for the state Department of Public Health said.

The state agency has asked local health authorities to inspect stores to determine if they carry the potentially contaminated toothpaste and to ask shop owners to discard it.

Consumers with questions or concerns should contact their local board of health or the Food Protection Program at the state Department of Public Health, at 617-983-6712.

By Alice Dembner, Globe Staff

A program that helps low-income patients manage chronic illnesses will receive $1 million in state funding this fiscal year, under the compromise budget approved by the Legislature on Monday.

The funding for CenterCare is a big drop from the $2.7 million allocation last year, but it is not as deep as Governor Deval Patrick and the House of Representatives had proposed. Patrick is reviewing the entire state budget and could veto money for the program, which is run through 30 community health centers statewide.

But CenterCare supporters said they were lobbying hard to ensure that doesn't happen, and plan to seek more money in a supplemental budget later in the year.

"It's still at less than half strength," said Patricia Edraos, policy director of the Massachusetts League of Community Health Centers. "But it gives us something to build on."

Even if the governor approves spending the money, it's unclear how much would go to a branch of the program at Holyoke Health Center, the subject of a Globe story on June 19. The center has helped hundreds of patients with diabetes adopt healthier lifestyles and reduce their blood sugar levels.

By Liz Kowalczyk, Globe Staff

Wait a minute!

Five medical-provider groups say they have major objections to CVS Caremark's plan to open 20 to 30 MinuteClinics in Boston-area stores by the fall.

In a letter this week to state public health Commissioner John Auerbach, the groups called for a public hearing on the proposal; they said his department should not waive certain clinic requirements for CVS without a hearing and vote by the Public Health Council. CVS wants a waiver of many normal clinic licensing requirements, such as having blood collection equipment because the clinics won't do blood tests.

The groups objected to granting waivers of "basic public health protections and standards of care to a for-profit company in order to reduce the economic burden to that company in competing with other health care providers. ..." They said a waiver would be unfair to medical providers struggling to meet regulations.

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By Stephen Smith, Globe Staff

Nine out of 10 families that have a relative living in a Massachusetts nursing home would recommend the facility to other relatives and friends, according to a state survey released today.

The survey, which was conducted from February through April and drew nearly 21,000 responses, gave nursing homes good grades in categories ranging from the quality of staff to the quality of food. When asked to rate their overall satisfaction with their relatives' nursing home, family members on average gave scores above 4 (satisfied) on a scale of 1 (very dissatisfied) to 5 (very satisfied).

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By Stephen Smith, Globe Staff

Two nurses and an auditor in an outpatient cancer clinic at Cape Cod Hospital in Hyannis have been diagnosed with whooping cough, hospital and state public health authorities said today.

The hospital is contacting patients potentially exposed to the hospital workers and providing them with antibiotics, said Donna Rheaume, spokeswoman for the state Department of Public Health.

Whooping cough is a highly infectious bacterial disease transmitted by coughing and sneezing. Typically, the disease arrives with symptoms similar to those of the common cold, but then progresses to spasms of coughing.

At its worst, a rattling, rib-cracking cough can linger for months and cause patients to lose sleep and weight. Studies have shown that 62 percent of adults with pertussis are still coughing three months after symptoms appear.

While symptoms can be persistent, the disease rarely kills otherwise healthy adults. But like any infection, it can pose a more significant threat to patients with chronic illnesses and impaired immune systems -- such as those with cancer.

Children have been routinely vaccinated against whooping cough for decades, but specialists know that the effectiveness of the shot wanes over time, leaving adults and some teens vulnerable to the infection unless they get a booster shot.

By Stephen Smith, Globe Staff

With apologies to Hillary Rodham Clinton: When it comes to public health, it takes a village.

But 351?

That's the question the state's new public health commissioner, John Auerbach, is asking. Massachusetts now has a crazy quilt of 351 public health boards -- one for every city and town. Some are so small that on certain afternoons, especially Fridays, they simple close down.

Auerbach told the state's Public Health Council today that he intends to explore the feasibility of creating regional public health networks to maximize expertise and assure responsiveness.

"There has to be a solution other than the current way of functioning," Auerbach said in an interview. "Most other states have already figured this out. We're the exception."

Florida, for example, which has three times the population of Massachusetts and considerably more land mass, has 67 county health departments.

By Stephen Smith, Globe Staff

Maybe Al DeMaria can finally get a little rest now.

DeMaria has been holding down multiple jobs at the Department of Public Health: the state's director of communicable disease control, chief medical officer and head of the State Laboratory Institute in Jamaica Plain. DeMaria's is a well-known face at the agency and on TV, especially when viruses or bacteria go on a rampage.

Now, the lab, which analyzes blood samples and other material taken from patients, is getting a full-time director -- and DeMaria is getting a break.

In June, the veteran chief of a comparable lab in Iowa will become director of the 113-year-old Massachusetts facility, which would play a pivotal role in the event of a global influenza epidemic or amid a biological or chemical threat. Mary J.R. Gilchrist, director of the University of Iowa's Hygienic Laboratory for the last 11 years, is a nationally recognized microbiologist and author of more than 100 textbook chapters and other publications.

DeMaria will continue -- perhaps better-rested -- as disease chief and medical director at the health agency.

By Stephen Smith, Globe Staff

The wave of gastrointesinal illness that swept Boston in recent months spawned 18 outbreaks in colleges, day care centers, and healthcare facilities, ranging from eight cases to 438, according to a report released today by the Boston Public Health Commission.

Disease trackers from the city confirmed that the illnesses were caused by norovirus, the same germ that ignited outbreaks across the nation this past winter.

Boston's sophisticated disease tracking system found that the number of patients showing up at emergency rooms complaining of gastrointestinal ailments was significantly higher from December 2006 through April 2007 than the comparable period a year earlier. Over a 19-week period, an average of 95 patients a day flocked to ERs with norovirus symptoms, compared with 78 a day the year before.

By Elizabeth Cooney, Globe Correspondent

Tufts Health Plan has quietly loosened its restrictions on weight-loss surgery, expanding who can get insurance coverage for the operations and shrinking how much time patients must first spend in a counseling program.

The restrictions were criticized by the state Department of Public Health, patients and surgeons even before they went into effect in March.

In a statement issued yesterday in response to questions about its new policy, Tufts said it was committed to offering its members the best chance for long-term success.

"Working most closely with bariatric surgeons at Tufts-New England Medical Center, we jointly agreed to guidelines for the coverage of bariatric surgery," the statement said.

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By Stephen Smith, Globe Staff

A leading legislative voice on health affairs today applauded public-health authorities for moving to scrap restrictions on stem-cell research -- and took some not-so-subtle swipes at the former administration of Mitt Romney.

State Representative Peter J. Koutoujian, chairman of the House Committee on Public Health, urged the state's Public Health Council to follow the recommendation of administrators to abandon stem-cell regulations adopted last August under the Romney administration. Governor Deval Patrick last month also decried the restrictions.

"It is wonderful to be working with a new administration with a commitment to public health," said Koutoujian, a Waltham Democrat. And he said that as the Public Health Council considers rolling back the restriction, it should engage in a discussion driven by scientific evidence "rather than one that would be pressured by an external political agenda."

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By Stephen Smith, Globe Staff

A coalition leading the fight against obesity in Boston won a $500,000 grant today, money that will be used to draft a citywide battle plan and to expand public space for physical activity.

The two-year grant was awarded by the W.K. Kellogg Foundation to the Boston Food and Fitness Collaborative, a 52-member association that includes hospitals and health centers, city agencies, and activist groups. The collaborative intends to make affordable produce available to residents as well as improve walking and bicycling trails, according to the office of Mayor Thomas M. Menino.

In two years, the coalition could receive an addition $3.5 million from the Kellogg Foundation to further implement strategies emerging from the citywide plan to combat obesity.

By Stephen Smith, Globe Staff

The House Ways and Means Committee today dealt a serious setback to Governor Deval Patrick's proposal to significantly expand public health services, eliminating or scaling back several of the governor's key initiatives.

The House budget contains no money for cervical cancer vaccines for girls, while Patrick had proposed spending $12.5 million to inoculate about 42,000 11- and 12-year-olds.

"I'm disappointed," said John Auerbach, the state's new public health commissioner. "I believe that making the vaccine available would have been a valuable public health initiative, given the data that show that this vaccine can be very helpful in terms of preventing cancers."

The governor's call to substantially reinvigorate the state's decimated Tobacco Control Program was also dealt a blow: The House budget contains only $8.2 million for anti-smoking campaigns, compared with Patrick's request for $16.2 million.

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By Stephen Smith, Globe Staff

The former chief of the state's HIV/AIDS Bureau and a top United Way official were appointed assistant secretaries of health today by Dr. JudyAnn Bigby, Massachusetts's health secretary.

Jean McGuire, who was an assistant commissioner in the Department of Public Health from 1997 to 2003, is the new assistant secretary for disability policies and programs. McGuire presided over the AIDS division at the public health agency before leaving for a position at Northeastern University. Early in her career, McGuire's work focused on special education and rehabilitation of adults with significant disabilities.

Marilyn Anderson Chase will be assistant secretary for children, youth, and families. Chase spent 10 years as senior vice president for community impact at the United Way of Massachusetts Bay.