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.

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.

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.

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."

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.

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.”

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.

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.

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.

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."

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.

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.

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."

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.

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.

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.

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.

(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.

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."

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.

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.

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."

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."

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.

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.

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."

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.

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.

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.

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 yea