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GWEN IFILL: Hundreds of children across the country have been hospitalized by a virus that has come on suddenly and strongly.

Jeffrey Brown gets the latest on what you need to know.

JEFFREY BROWN: It’s called Enterovirus 68, and it’s led to a surge of emergency room visits. In many ways, it starts off much like a regular cold, but some children soon have wheezing or breathing difficulties.

The virus has been confirmed in at least six states so far, Colorado, Illinois, Iowa, Missouri, Kansas, and Kentucky, and at least six others are reporting cases.

We talked with two people who are dealing with it directly, Dr. Anne Schuchat of the Centers for Disease Control, and Dr. Gregory Conners of Children’s Mercy Hospital in Kansas City, one of the first hospitals to report it.

And, Dr. Conners, let me start with you. What did you and your colleagues see that caused alarm and caused you to reach out to the CDC?

DR. GREGORY CONNERS, Director, Division of Emergency and Urgent Care, Children’s Mercy Hospital: Sure.

Well, about five or six weeks ago, a couple of my colleagues realized that we were seeing more than expected, quite a bit more than expected, in the number of children presenting to emergency departments and our urgent care centers with complaints of, as you said, wheezing, coughing, lower respiratory symptoms.

And so this got to our infectious disease folks, who said this looks like a novel or unusual viral outbreak, let’s get in contact with the CDC. And testing began and we came to realize that it was this enterovirus that you just described.

JEFFREY BROWN: And how many — when you say more than usual, how many cases?  How big a deal has it become?

DR. GREGORY CONNERS: Right.

Well, in the past four or five weeks, we have seen an average of over 100 kids a day beyond our usual, so we’re seeing about 100 kids a day with this now.

JEFFREY BROWN: So, Dr. Schuchat, what do we know about the virus and why it’s spread now?

DR. ANNE SCHUCHAT, Centers for Disease Control and Prevention: Enteroviruses are quite common. There are 10 million to 15 million infections each year.

But Enterovirus 68 is quite unusual. It’s been seen — it’s been known of since 1962, but we haven’t seen very many of these infections here in the U.S. What we’re seeing this year in a couple of places is an increase over expected of severe respiratory illness in children, worsening of asthma in particular.

We think that the virus is spread person to person through coughs and sneezes, and that it’s really important for people to wash their hands, cover their cough, keep their kids home if they’re sick, those sorts of things, really what we call respiratory hygiene or good etiquette, to try to reduce that spread of respiratory virus from one person to another.

CAVUTO: Do we know why it suddenly flares up?  You said it’s been around since the ’60s, but in very low — low levels, I guess.

DR. ANNE SCHUCHAT: We wish we knew more about this virus. It’s relatively new. We know that the strains circulating this year are quite similar to last year’s and the year before, so it hasn’t suddenly changed.

But, for some reason, we’re seeing increases in particular communities. CDC is working closely with states and local health departments around the country to understand whether the increases or clusters of respiratory illness are caused by this. There are many other causes of respiratory illness. And in some of the clusters we have looked into, this hasn’t been present. So it’s early days, and we will know a lot more in the next weeks.

JEFFREY BROWN: And do we know why it hits — seems to hit children with respiratory problems already?  Is that correct?

DR. ANNE SCHUCHAT: Right.

Enteroviruses in general cause more symptoms in young people than in adults. Adults can get milder asymptomatic infections with these viruses. The Enterovirus 68 seems to worsen asthma. So many of the cases we have seen have been children who have asthma who have a worse time recovering from the virus.

We think it’s important for parents who have children with asthma to make sure their kids are taking their medicines regularly. And flu season is coming. And influenza vaccine is an important protection for children with asthma and others with asthma. They just don’t handle viral infections as well as others do.

JEFFREY BROWN: Well, so, Dr. Conners, tell — what has happened in the cases that you have seen?  What’s been — when have children come in and what has sort of been the progression as they come in?

DR. GREGORY CONNERS: Sure.

We have seen quite a lot of kids. And they have come in with symptoms suggestive of asthma. Many of them — many of them have asthma, and many of them haven’t had asthma in the past, but yet look like they do have asthma.

We have had to admit about one in six of those children to the hospital, some even to intensive care, and the rest we have been able to treat with enough medication in the emergency department, and we can then send them home to continue their management at home.

But some kids, especially the ones with underlying health problems already, including asthma, some of them have ended up in intensive care.

JEFFREY BROWN: And what kind of treatment is it?

DR. GREGORY CONNERS: Sure.

Well, we use really standard asthma stuff, inhaled medicines, and then usually oral steroids. That will get through most of the kids who have an asthma-like picture. The ones who come into the hospital, we have to use those more intensively than you would use at home. And then the ones in intensive care often need extra oxygen and intravenous medications as well.

JEFFREY BROWN: And what do you tell parents or what would you tell parents about when they should bring a child in either to the doctor or clearly to an emergency room if necessary?

DR. GREGORY CONNERS: Sure. That’s a great question.

What we tell parents is to bring their kids in if they’re having trouble breathing or symptoms that really need an emergency or an urgent care visit. We have had several families who have come in since they have learned more about it on the news with concerns that — concerns that this might be that virus, and the children actually weren’t that sick, looking for specific testing or that sort of thing.

And we tell parents, no need for that. Come in if your child needs help because they’re sick to the level of needing emergency or urgent care. But if you’re looking for specific testing, we will just examine your child, says it looks like that what it probably is. No need for specific testing.

And there is no specific therapy even if the tests were positive. So just take care of your child as you usually would and consider the emergency department and urgent care to be kind of a backup if your child is having trouble breathing or some other important health care problem like that.

JEFFREY BROWN: And let me ask you, Dr. Schuchat, briefly, finally, is there any — does history tell us anything about how long something like this might last or how big it might grow?

DR. ANNE SCHUCHAT: We’re reviewing the information that’s available from outbreaks around the world.

Usually, this is the right time of the year. August and September are when enteroviruses peak. But we really don’t know exactly how long this will last in the different communities or how widespread it will be. We do think that, in the weeks ahead, it will be important to be looking for other viruses as well, because we will be heading into the season when different viruses circulate.

So it’s not likely to go on for months, but this is the right time of year for this kind of respiratory problem.

JEFFREY BROWN: All right, Dr. Anne Schuchat of the CDC, Dr. Gregory Conners of Children’s Mercy Hospital in Kansas City, thank you both very much.

DR. ANNE SCHUCHAT: Thank you.

DR. GREGORY CONNERS: Thank you.

The post What you need to know about the rare respiratory virus affecting kids appeared first on PBS NewsHour.

According to the World Health Organization, more than 1.4 billion adults are overweight and more than 500 million are considered obese — a number that has more than doubled since 1980. Both conditions increase the risk for heart disease which is the leading cause of death globally, taking 8.5 million lives a year.

The numbers are clear. But what is less quantifiable is the strain that the obesity epidemic has put on health services. London-based bariatric surgeon Dr. Hutan Ashrafian sees the effects of the disease daily, and his long patient list signals no end in sight. So he and a team of researchers began a search for digital-age tools that could help physicians effectively manage and track patients remotely.

The team first set out to find other instances where web-based tools and social media played a role in the treatment for obese and overweight patients. They then analyzed the studies’ effectiveness at reducing patients’ body mass index, or BMI. Their goal was to provide evidence of what innovative methods could be developed to help combat the lethal disease. Their study revealed promising results:

Our analysis of twelve studies found that interventions using social networking services produced a modest but significant 0.64 percent reduction in BMI from baseline for the 941 people who participated in the studies’ interventions. We recommend that social networking services that target obesity should be the subject of further clinical trials.

PBS NewsHour interviewed Ashrafian to hear what the team learned from the 12 studies that they analyzed, the results of which are published in September’s issue of Health Affairs.

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NEWSHOUR: To start with, can you explain what significant although modest really means?

DR. HUTAN ASHRAFIAN: Significant means that in terms of statistical evidence it is significant, i.e. mathematically if you look at the results, they stand out because there is consistency in the result that we got throughout all the studies, so there is a definite and consistent effect to all the studies we looked at where we demonstrated that if you use social media people consistently are able to lose weight across all the studies we looked at.

NEWSHOUR: And the modest part?

DR. HUTAN ASHRAFIAN: Now the modest part is where we added and integrated all the information from the different studies; we used a marker to measure obesity to see how much social media was able to decrease their obesity once they had a social media intervention. And so when you add up all the number and look at it though the different groups that were studied, the results were relatively modest drop in the body mass index which is a measure of obesity. A body mass index measure is the number we use for height-to-weight ratio to measure obesity. Eighteen to 25 is normal, above 25 is overweight, above 30 is obese.

This drop overall from all the studies was .64 percent. The way I explain it to people is that when we look at the temperature around the world, and when we say oh look the national average temperature is going to go up by one percent, people say well one percent isn’t a big amount of temperature change, but that’s the average over the whole year so it means potentially there will be people who will lose much more and some much less, but overall there as a powerful effect.

NEWSHOUR: Why do you think it is vital health care providers and policy makers consider what you’ve learned?

ASHRAFIAN: If you have the right setup to manage patients remotely and have them manage their health care at the same time, you could have a successful treatment modality that is cost effective, and a gold standard for future treatment introduced. It is a problem affecting all classes of individuals, and a worsening issue, so we need to use as much innovation as we can. The nature of obesity has been demonstrated to exist in society through a social network. As a result, one potential therapeutic modality to combat obesity is to match the diseases’ network elements with a network-based treatment such as social networking services

NEWSHOUR: Your team analyzed 12 other studies that used social media. What was the concept behind the different methods?

ASHRAFIAN: They were all Internet-based platforms where people can report their personal results, and also get advice either individually or in a group setting to improve their weight loss.

It is a mixture of a clinic with a weight loss group combined, so it takes the best of both worlds.

NEWSHOUR: The strategy involves both personalized and group attention from the doctors. Can you explain how these come together for success?

ASHRAFIAN: The magic thing about it is the familiarity with the patients.

If you were having problems eating that week, the doctor can quickly say, “ok what was causing it, were you going through something at work, was it that you hurt your knee whilst running?” So the patients were getting lots of support and feedback on their outcomes.

It gives doctors an extra tool to help manage patients, but primarily it means they can decrease their clinic list. It would free their time, at the same time as seeing and addressing the needs of many, many patients. The commonality of having specialists who are used to doing online work for patient care as a routine would be an important part of the future.

Then there’s motivational support from peers in the groups. If someone lost a large amount of weight, they would all be able to communicate on the group and say “oh well done congratulations that is excellent, superb work.” It means that people around them caring for them will potentially be celebrating their success, and that is a huge motivation factor.

NEWSHOUR: What did you learn about the relationship between social networks and BMI reduction?

ASHRAFIAN: There is a definite and consistent effect to all the studies we looked at, where if you use it consistently, people are able to lose weight. Clearly, a lot needs to be done to address obesity, but this could be one of the arms of an armamentarium to break down a massive worldwide epidemic. It really comes down to, these methods have been shown to work and they have the potential to be cost effective in application. However, the results of our studies are relatively modest because of how many studies are out there.

NEWSHOUR: How can social networking strategies ultimately augment policy driven health care reforms?

ASHRAFIAN: The issue with obesity is that it is a multifactorial disease that has elements of diet, elements of lifestyle, elements of behavior, access to food, associated economics, and genetics. It is not an easy disease to treat because we haven’t been able to treat it well for almost half a century now. Clearly the treatments for obesity need to be so multifactorial and flexible to address all those elements and social networking services are so flexible as a strategy that they can attack many of those elements through online communication. And so if you are able to tailor make your social networking services to directly target every one of those factors that lead to obesity you would be on the road to achieving a big dent in the breadth of obesity we have worldwide.

Editor’s note: This interview has been edited for clarity and length.

The post How doctors can use social media as an obesity reduction tool appeared first on PBS NewsHour.

Premiums for job-based insurance rose modestly for the third consecutive year, reflecting slowed spending, even as key elements of the federal health care law went into effect.

Family premiums rose 3 percent in 2014, one of the lowest increases tracked since the Kaiser Family Foundation and the Health Research & Educational Trust began surveying employers in 1999. (Kaiser Health News is an editorially independent program of the foundation.)

Nonetheless, the cost of the average family plan rose to $16,834 annually, according to the survey of more than 2,000 employers nationwide.

While both critics and supporters of the Affordable Care Act are likely to find fodder for their positions, the report portrays 2014 as a relatively stable year for employer coverage, with little change in the type of plans offered or their costs. The percentage of firms offering health benefits (55 percent) and the percentage of workers covered at those firms (62 percent) were statistically unchanged from 2013, despite predictions of the law’s critics that many firms would drop coverage.

“We’re in a period of very modest premium increases where the feeling that the employer-based system is unsustainable may cool, at least for a while, until we see higher increases in premiums again for group insurance,” said Drew Altman, president and CEO of the foundation. “No one knows when we might see that again or how sharp those increases may be.”

In recent years, employers have been shifting more costs to workers, including raising workers’ deductibles, or the amount people have to pay before most benefits kick in.Total premium costs for single coverage remained about the same, hitting $6,025 a year. And workers paid the same percentage of the premium as they have for the past several years, about 29 percent for family coverage and 18 percent for single plans.

In recent years, employers have been shifting more costs to workers, including raising workers’ deductibles, or the amount people have to pay before most benefits kick in. However, the survey found that there was no significant change in deductibles this year.

In 2014, the average deductible for single employees was $1,217, a 47 percent increase since 2009. Employees at small firms paid even more, averaging $1,797.

Among the changes noted by the survey: The percent of covered workers potentially liable for more than $6,350 in out-of-pocket costs under their plans, dropped from 14 percent in 2013 to 7 percent this year. The health law caps out-of- pocket costs, although some employers could go over that amount this year.

But the report warns that insurance may look different in 2015.

For the first time, employers with 50 or more workers are slated to face fines if they don’t offer coverage, a provision that was supposed to begin this year, but was delayed by the Obama administration.

Although 92 percent of companies with 50 or more workers already offer coverage, the survey notes that some of those employers may change eligibility rules, or the amount they pay toward coverage. Conversely, some firms may offer workers coverage for the first time to avoid fines.

Other employers, especially small ones, may decide to drop coverage, sending workers to state and federal marketplaces to buy individual policies. That was also a concern this year, but the survey found that the percentage of firms offering coverage was 55 percent, down from 57 percent the prior year, a change that wasn’t statistically significant.

On Tuesday, the credit rating firm Moody’s also issued a report, noting that employers did not drop coverage this year “primarily because [they] were not ready to ‘dump’ their employees into an untested public exchange.”

Moody’s analysts said they did not think employer fines in 2015 will have much effect because “most employers already are providing health benefits to their employees.”

Still, if the economy improves and spending on health care ticks up as consumers seek elective care they had previously delayed, that could drive up premiums, the Kaiser report notes.

Since 1999, premiums have risen an average 191 percent, with the fastest growth seen between 1999 and 2004, the report found. Even as employees’ share of the total premium has remained about the same, the total dollar amount has risen. This year, workers paid an average $1,801 toward the premium for a single plan and $4,823 toward a family plan premium.

Since the mid-2000s, annual premium increases slowed to less than 10 percent each year. This year tied with 2010 for the smallest increase, at 3 percent for family coverage.

Since those are averages, some employers and workers will have seen higher increases.

Gordon Gondek, co-owner of Dixie Restaurants in Little Rock, Ark., has about 100 employees eligible for health benefits. He said his premiums went up 12 percent this year, “which was pretty much to be expected,” said Gondek.

He’s not sure what increase he may see next year, but said the firm is “doing everything that we can to hold down our costs.”

Smaller rate increases during the past three years are attributed mainly to lower growth in health care spending overall, related to the slow U.S. economy.

Some employers are already getting a glimpse at next year’s costs.

Debby Terzo, the chief operating officer at Shattuck National Bank in Shattuck, Okla., said its insurer quoted a 30 percent increase next year to cover 15 full-time employees. “I kind of looked at it, and I thought, ‘wow.’ I put it in a drawer because I didn’t want to think about it,” she said.

Employers facing such increases often take steps to lower premiums by increasing deductibles, or the amount workers’ pay out-of-pocket for doctor office visits, drugs or hospital care.

About 41 percent of workers have an annual deductible of at least $1,000, while 18 percent pay at least $2,000 a year, according to the survey.

“One of the reasons why we have moderate premium increases is because deductibles are going up, plans are becoming less generous and it makes people more sensitive to whether they use health care,” said Paul Fronstin of the Employer Benefit Research Institute, a Washington think tank.

Shefali Luthra contributed.

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Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.

The post Employer-provided health care costs saw only modest increases in 2014 appeared first on PBS NewsHour.

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JUDY WOODRUFF: In West Africa, doctors are fighting the world’s most deadly Ebola outbreak with makeshift hospitals, a handful of vehicles and a few brave volunteer health workers. Meanwhile, terrified villagers and city-dwellers alike can only watch helplessly as their loved ones succumb to the disease.

Tonight’s episode of “Frontline” on PBS takes an intimate and harrowing look at all this on the ground in Sierra Leone. In the following scene, “Frontline” cameras travel with a group of health workers who go to remote villages, searching for Ebola’s victims.

NARRATOR: They’re heading to a village where Ebola has already killed an old man. Everyone they encounter, even those who look healthy, could be infectious.

The team used to wear protective clothing, but the suits terrified the villagers, who ran, hid and sometimes even attacked them. Manjo now relies on keeping his distance from everyone he meets.

MANJO: My name is Manjo, and this is Ishata (ph) from the World Health Organization.

NARRATOR: A young woman is clearly unwell.

MANJO: What’s wrong with you?

NARRATOR: Kadiatu Jusu (ph) is 25 years old, the mother of four children.

WOMAN: Do you have a fever?

WOMAN: Yes, I have temperature, diarrhea and I’m vomiting.

NARRATOR: Her husband, Fallah (ph), is a farmer. He’s 35. It was his father who died two weeks ago. Ishata Conteh (ph) can see Kadiatu is almost certainly infected.

WOMAN: She actually fits into the case definition, because she was the one taking care of the old man, feeding him, cleaning where the old man was vomiting, and there was direct physical contact.

MANJO: I’m going to spray this area.

NARRATOR: Manjo disinfects Kadiatu’s home with chlorine. Everything she touched could have been contaminated. Ishata notes the names of everyone who’s been in close contact with Kadiatu. Her children and husband are at the top of the list.

WOMAN: Seventeen. All these 17 people here. If anyone gets a fever or the cough or feels like they have malaria or pain all over their body or is vomiting or going to the toilet a lot, any of those symptoms, you must call us. They are all at risk. We need to monitor them for the next 21 days.

WOMAN: She, too, is going with the same thing.

NARRATOR: Fallah can’t risk touching his wife to say goodbye.

JUDY WOODRUFF: And that’s from a “Frontline” episode airing tonight.

As we reported earlier, the number of Ebola deaths in this latest outbreak now tops 2,300.

To find out what the U.S. is doing to combat the deadly epidemic, I’m joined by Nancy Lindborg. She’s assistant administrator at the United States Agency for International Development, which has been heading up the government’s response to this growing crisis.

Nancy Lindborg, thank you for joining us.

Again, how typical would you say that scene is that we just watched?

NANCY LINDBORG, U.S. Agency for International Development: I think that scene was, unfortunately, very typical, and what we’re seeing is an unprecedented outbreak that is occurring across West Africa, but particularly focused in countries that are only recently emerging from decades of civil war.

So they had very fragile health systems to begin with. And they also have practices that are enhancing the spread. You heard about the burial practices that involve touching the dead. So we are working on a strategy across the U.S. government that involves USAID, Centers for Disease Control, and DOD, State Department to work with the global community and countries on the ground to help stop the transmission, to expand treatment, and to stand up greater capacity at the local level to do exactly what you saw, be able to address this.

JUDY WOODRUFF: It’s clear that this is an epidemic that is much worse than was thought just a few — a matter of certainly a few months ago, even a few weeks ago.

What is the U.S. responsibility in all this?  At this point, there is not an Ebola patient in the U.S., except those who have been transported to the U.S. from West Africa. But what is the U.S. responsibility in this?

NANCY LINDBORG: Our responsibility as a global leader is to do what we can to contribute to that stopping of the transmission and the provision of the treatment and helping these countries stand up better systems.

We’re working closely with the global community, and this is really going to take an all-hands-on-deck kind of approach. We just announced this morning a $10 million contribution to the African Union as they mobilize a continent response. They have mobilized 100 health workers who are going in and will provide the logistical support for them to be successful.

This will — we know what it takes to stop this. We also know that it will take significant ramping up by all the various partners, and it will probably take several months to get this under control.

JUDY WOODRUFF: Ten million dollars, is that enough at this point?  Is that just a drop in the bucket?  I mean, how do you compare that to the challenge out there?

NANCY LINDBORG: That’s — that was just to support the African Union mobilization.

USAID has committed about $100 million. We have got additional commitments from the Department of Defense. They’re bring in diagnostic labs, a field hospital. We’re bringing in almost a daily airlift of supplies, the protective personal gear that you saw people wearing, the backpack sprayers, household kits, so that households have what they need to take care of loved ones and keep themselves safe, food, a whole variety of supplies.

JUDY WOODRUFF: What — is the U.S. able to understand and to — I mean, is — do you now have a list somewhere that says, OK, here are all the things that are needed, and we’re going to provide these things, or are you still figuring this out as you go along?

NANCY LINDBORG: We have a very clear strategy that we’re pursuing, in coordination with the World Health Organization, with the local countries and their health systems and with our partners, the Europeans and the African Union.

There is — it’s stop the transmission, expand the treatments, and set up local systems, and also help the home health care strategy, so that people are not continuing to handle the dead the way that they do and to — and practice the kind of daily health practices that can change forever the way this is transmitted.

JUDY WOODRUFF: But that means getting more people on the ground to spread the word, doesn’t it?

NANCY LINDBORG: Absolutely. Absolutely.

Well, both to spread the word and to help with the setting up of the treatment facilities.

JUDY WOODRUFF: And as you — as you — at this point, is this a matter of resources, or is it a matter of time, people?  What is it that’s needed the most to bring this raging epidemic under control?

NANCY LINDBORG: It’s really all of the above.

It’s surging in the supplies. It’s surging in the people who are trained to have the very rigorous protocols required to provide the treatment. It’s activating all the ways that we can provide the information to people in the communities. We are — we have surged about 100 people into the region of USAID.

JUDY WOODRUFF: Americans?

NANCY LINDBORG: Of American, USAID, CDC, Department — the DOD, all parts of the U.S. government on the ground to get us moving ahead and further identify how to plug in, how to activate a coordination system on the ground.

JUDY WOODRUFF: How much are you concerned?  What are the odds, the chances that Ebola could spread to the United States?

NANCY LINDBORG: You know, part of what we have done is brought in a lot of those thermometers that you saw the health workers using, and set up the kind of screening that is done at the airports, so that there’s that additional control.

There’s — we always want to be concerned about global epidemics, but this — this is controllable and this is — what we have seen is, as it’s spread to places like Senegal, that they have the systems to do the tracing, the treatment, and they’re able to keep it from spreading.

Ultimately, there needs to be strengthening of the health systems, so that when these kinds of cases appear, there can be the kind of immediate response that keeps it from becoming the kind of really terrible outbreak that we’re seeing right now.

JUDY WOODRUFF: An enormous task.

Nancy Lindborg with the U.S. Agency for International Development, we thank you.

NANCY LINDBORG: Thank you.

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