NIH Announces Funding for New Technologies for Viral Hepatitis

The National Institutes of Health (NIH) has issued a funding opportunity announcement (FOA) to encourage small businesses to address viral hepatitis research opportunities delineated in the Action Plan for the Prevention, Care, and Treatment of Viral Hepatitis (Action Plan) [PDF 2MB]. The announcement of a Small Business Innovation Research (SBIR) grant entitled New Technologies for Viral Hepatitis SBIR (R43/R44) is supported by 3 participating institutes: the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), the National Heart, Lung, and Blood Institute (NHLBI), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD).

The FOA “encourages small business establishments to submit applications that address any of the specific research topics in the updated Action Plan for the Prevention, Care & Treatment of Viral Hepatitis that are assigned to the NIH and germane to the research mission of the respective NIH Institutes and Centers, in order to facilitate the development, evaluation, and validation of products that would be implemented in the public health efforts to reduce the burden of viral hepatitis in the United States.” Research objectives and strategies from the Action Plan that are relevant to this FOA include (but are not limited to) the development of: rapid screening tests, new diagnostic tests, tests for viral hepatitis-related complications, practical models of care, new and improved therapies to treat viral hepatitis or manage complications of disease or antiviral treatment, genetic-based tests for patient management or treatment selection, preventive vaccines, innovative approaches to pathogen identification and reduction in blood products.

Eligible applications include: new applications (Phase I, Fast-Track), renewals (Phase II), resubmissions (all phases), Phase IIB competing renewals, and revisions. Award amounts and durations are limited to 6 months and $150,000 for Phase I grants, and 2 years and $1,000,000 for Phase II grants. This FOA will be open for submissions beginning March 5, 2015.

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Disability & Benefits: Family & Medical Leave Laws —Jacques Chambers, CLU

The federal government as well as eleven states plus the District of Columbia have enacted laws providing protection to employees who must be off work due to a medical condition of their own or that of a family member.

It is important to note that the laws do not require employers to continue any part of the worker’s salary while the employee is not working. Any income would have to come from another source, such as the employer’s sick leave and/or Short Term Disability plan, or Worker’s Compensation if it’s a job-related condition, or from state mandated disability benefits programs in California, Hawaii, New Jersey, New York, or Rhode Island.

Federal Family & Medical Leave Act (FMLA)
The federal FMLA law primarily does only two things. If you are an employee who has to take time off from work due to a serious medical condition, either your own or that of a family member, the law:

• Protects your job while you are off work caring for either yourself or a family member with a serious medical condition so that your job will be available when you return to it;
• Requires employers to continue your employee benefits in the same manner as it did when you were working; and,
• Covers only the first twelve weeks of absence in a 12 month period.
• It does NOT provide any financial benefits. That must come from other sources

Here are the main provisions of the federal FMLA:

Who is covered under the law?
Employers engaged in commerce, or an industry or activity affect­ing commerce, are covered by the law if 50 or more employees are employed in at least 20 or more calendar workweeks in the current or preceding calendar year. The right to take leave applies equally to male and female workers who are employed at or within 75 miles of the work place by an employer of 50 or more workers.

The FMLA also applies to all public agencies, state governments and political subdivisions (including the District of Columbia, U.S. territories and possessions), elementary and secondary school systems, and institutions of higher education. There are special provisions for classroom teachers so as not to disrupt the learning process of students.

Who can take advantage of the law?
An employee is eligible to take FMLA leave if:

• The employee has been employed by the employer for at least 12 months which need not be consecutive; 
• The employee has been employed for at least 1,250 hours of service during the 12-month period immediately preceding commencement of the leave;
• The employee is employed at a work site where 50 or more employees are employed by the employer within 75 miles of that work site;
• The employee is not a “key” employee;
• The employee’s position has not been scheduled for elimination.

For what reason may an employee take time off under the law?
The FMLA requires covered employers to grant eligible employees up to 12 weeks of unpaid, job-protected leave in any 12-month period to care for family members or because of their own serious medical condition. FMLA leave may be granted for the following reasons:

• The birth of the employee’s child and care of the infant;
• The placement of a child with the employee for adoption or foster care;
• The care of a spouse, child, or parent of the employee if the spouse, child, or parent has a serious health condition; or
• The employee’s own serious health condition renders him or her unable to perform the essential functions of the job.

A non-chronic, short-term illness or injury that requires an employee to be absent from work a day or two at a time may qualify as part of the employee’s entitlement to job-protected leave under the FMLA as long as the illness or injury is a serious health condition.

What is a “serious health condition” under the law?
The law defines “serious health condition” to include any “illness, injury, impairment, or physical or mental condition that involves” either inpatient care or “continuing treatment” by a “health care provider.” The Department of Labor regulations expand this to include an illness, injury, impairment or physical or mental condition that involves: (1) inpatient care, including any period of incapacity or any subsequent treatment in connection with the inpatient care; or (2) continuing treatment from a health care provider.

What happens to employee benefits while out on FMLA?
The employer continues any existing health insurance for the duration of the leave and at the level and under the same conditions coverage was provided before commencement of the leave. Employers can ask the employee to cover his/her share of the premiums that were previously paid through payroll deduction from the paycheck. Employers are not required to continue benefits such as life and disability insurance but they cannot require employees to re-qualify for benefits when the employee returns to work.

Is the position protected?
Yes, the employee must be restored to the original or an equivalent position with equivalent benefits, pay, and all other terms and conditions of employment. The highest paid 10 percent of salaried employees may be denied job restoration to prevent substantial and grievous economic injury to the employer.

What may the employer require to grant the leave?
An employer may require certification from a health care provider to support a claim for leave. But if an employer asks one employee for proof of a serious illness, the employer must ask all employees for equivalent certification.

Does the law apply to teachers too?
There are special rules that apply to “instructional employees” that are designed to minimize disruption in the classroom while still protecting the rights of the person on disability. The special rules apply to intermittent leaves, reduced leave schedules, and the taking of leave near the end of an academic term. More detailed information can be found in the Code of Federal Regulations (29 CFR 825.600 et seq).

Other provisions of the law

• Leave can be taken intermittently, is subject to employer approval, and does not result in a reduction in the total amount of leave to which the employee is entitled.
• When husband and wife work for the same employer, the total amount of leave that they may take is limited to 12 weeks if they are taking leave for the birth or adoption of a child or to care for a sick parent.
• When the need for leave is foreseeable, an employee is required to provide at least 30 days advance notice.

Does not supersede state laws
The Act does not supersede any state or local law, collective bargaining agreement, or employment benefit plan providing greater medical and family leave rights, nor does it diminish their capacity to adopt more generous family leave policies.

State Family & Medical Leave Laws
Many states have laws that apply to smaller employers or last longer than the twelve weeks of the federal law. Each state’s own law regarding family and medical leaves can vary considerably from the federal FMLA, so it is important that you check your own state’s law as well when contemplating taking time off for medical reasons.

Also, many of the state laws provide time off for employees to participate in their children’s educational activities either as part of their FMLA law or in a separate statute.

Most of the state laws offer benefits equal to or less than the federal FMLA. There are some exceptions where state law is broader:

• California – For maternity leave, offers 12 weeks of unpaid family leave plus 4 months of maternity leave for a total of 28 weeks per year.
• Maine – Law applies to private employers of 15 employees or more and state and local government employees with 25 employees or more, but limits leave to 10 weeks in 2 years.
• New Jersey – Only 1000 hours of service in twelve months are required to be eligible for its benefits.
• Oregon – Employers with 25 or more employees are covered, and employees are eligible after working at least 25 hours per week in the past 180 days.
• Vermont – All employers with 10 or more employees come under the law.
• Washington – All employers come under the law. Employees are eligible after working at least 680 hours during the past year.

Details on the state laws can be found at here:


http://hcvadvocate.org/news/newsLetter/2015/advocate0115_mid.html#5

Catch liver cancer early with regular screening

Liver cancer is one of the deadliest cancers in the world, causing more than 600,000 deaths each year. The number of Americans with liver cancer has been slowly but steadily rising for several decades with over 33,000 people expected to be diagnosed in 2014. The incidence is increasing due to the silent epidemic of hepatitis B and C, the rise in the number of people with morbid obesity and diabetes, and the persistence of alcoholic cirrhosis - all of which are risk factors for the disease.

Symptoms of liver cancer include loss of appetite, weight loss, feeling of fullness, nausea or vomiting, pain in the abdomen or near the right shoulder blade, and yellowing of the skin. Unfortunately, symptoms often do not appear until the disease is an advanced stage, which is why regular screening and surveillance are critically important for patients living with liver disease. Regular checkups in those without risk factors are also important as anyone can develop liver cancer.

"Patients often do not experience symptoms of liver cancer until it's already progressed to an advanced stage so it's important for those at risk to be screened," says Dr. Ghassan Abou-Alfa, medical oncologist at Memorial Sloan Kettering Cancer Center, chair of the Hepatobiliary Task Force of the National Cancer Institute, and a member of the American Liver Foundation's National Medical Advisory Committee.

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The Five: The Flu —Alan Franciscus, Editor-in-Chief

This year’s strains of influenza are particularly virulent, and unfortunately the vaccine developed this year does not provide protection against all of the strains.  The flu is a nasty virus that causes 36,000 deaths and 200,000 hospitalizations each year in the United States. The largest and deadliest flu outbreak was the Spanish flu pandemic of 1918-1919 that caused 20 to 40 million deaths.  Now we are lucky to have a healthcare system that prevents most deaths, and vaccines that provide protection against most strains of the flu. 

1. Symptoms:  Many people confuse the symptoms of flu with the cold, but the flu has definite symptoms, such as: 

• A fever of 100 degrees or higher (but not everyone gets a fever)
• A cough and/or sore throat
• A runny or stuffy throat
• Headache and/or body aches
• Chills
• Fatigue or feeling tired
• Nausea (feeling sick to your stomach), vomiting, and/or diarrhea

2. People who are at risk for severe complications:

• Children younger than 5, especially those younger than 2 years old
• Adults 65 years and older
• People who have medical conditions including liver disease (such as hepatitis B and C)

3. Prevention:

• The best prevention is the flu vaccination.  It is safe and is usually effective; but this year’s flu has mutated so the vaccine is not protective against this year’s most virulent flu strain.  Even so, it is protective against 50% of the strains infecting people this year.
• Basic hand washing can help to protect people from the cold, flu and other infections—wash the hands for at least 20 seconds with soap and water. 
• Watch what you touch, especially other people’s items—phones, iPads, remote controls, etc.

4. The Flu:

• If you get the flu, the best advice is to get bed rest, and monitor your temperature and drink lots of fluids.
• There are many over-the-counter medicines that can help lessen some of the symptoms
• Your medical provider can prescribe antiviral medications to reduce the symptoms and shorten the duration of the flu
• Seek medical attention if you experience any of the following:
• Difficulty breathing or shortness of breath
• Purple or blue discoloration of the lips
• Pain or pressure in the chest or abdomen
• Sudden dizziness
• Confusion
• Severe or persistent vomiting
• Seizures
• Flu-like symptoms that improve but then return with fever and worse cough

5. The Bottom Line:

• There is still time to get the flu vaccine, but if you don’t get vaccinated, be prepared to take precautions to protect yourself against getting the flu. 

http://hcvadvocate.org/news/newsLetter/2015/advocate0115_mid.html#4

Egypt: Mothers infecting children with hepatitis C in Egypt

Up to 5,000 Egyptian children a year could be infected by hepatitis C through their mothers.

A new study suggests that between 3,000 and 5,000 Egyptian children could be infected with hepatitis C virus (HCV) annually through mother-to-child transmission¹.

This vertical transmission, which is still not fully understood, is believed to occur during pregnancy, child birth or during the postpartum period, most probably from cracked nipples.

The scientists from the Weill Cornell Medical College in Qatar (WCMC-Q) and the London School of Hygiene & Tropical Medicine in the UK focused on Egypt, which has the highest incidence of HCV worldwide, with an estimated 14.7% of the population carrying the virus and up to 100,000 new infections occurring each year, according to WHO.

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Australia: Aboriginal Hepatitis C rising, prompting calls for improved services

As rates of the disease decrease among Australians overall, Hepatitis C is three times higher and rising in Indigenous populations.

Mainstream medical services are failing Aboriginal communities, where the rate of Hepatitis C is rising, a peak Aboriginal health body has told a federal Senate inquiry.

A public hearing in Sydney on Thursday heard submissions from stakeholders, including the National Aboriginal Community Controlled Health Organisation (Naccho), which called for improved access and funding of medical services for Aboriginal and Torres Strait Islander people.

As rates of the disease decrease among Australians overall, Hepatitis C is three times higher and rising in Indigenous populations, according to a 2013 study by the Kirby Institute. The worsening problem is mainly due to higher rates of unsafe drug injecting and possibly higher rates of incarceration, where the prevalence of intravenous drug use is much higher among Indigenous prisoners, according to multiple studies.

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High number of Hepatitis C cases in Mesa County

GRAND JUNCTION, Colo. It's called the "hidden epidemic" and is more aggressive and infectious than HIV. Hepatitis C starts as a liver infection and can turn into a chronic disease.

According to The Western Colorado Aids Project, Mesa County is one of the highest counties with Hepatitis C cases in Colorado and it's on the rise. WestCAP Director Jeff Basinger estimates that 3,000 to 5,000 people in Mesa County currently have the disease.

"We have a positivity rate that ranges from 25 to 50 percent of all people we test,” said Basinger.

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