Global Health: After Measles Success, Rwanda to Get Rubella Vaccine

Rwanda has been so successful at fighting measles that next month it will be the first country to get donor support to move to the next stage — fighting rubella too.

On March 11, it will hold a nationwide three-day vaccination campaign with a combined measles-rubella vaccine, hoping to reach nearly five million children up to age 14. It will then integrate the dual vaccine into its national health service.

Rwanda can do so “because they’ve done such a good job on measles,” said Christine McNab, a spokeswoman for the Measles and Rubella Initiative. M.R.I. helped pay for previous vaccination campaigns in the country and the GAVI Alliance is helping to finance the upcoming one.

Rubella, also called German measles, causes a rash that is very similar to the measles rash, making it hard for health workers to tell the difference.

Rubella is generally mild, even in children, but in pregnant women, it can kill the fetus or cause serious birth defects, including blindness, deafness, mental retardation and chronic heart damage.

Ms. McNab said that Rwanda had proved that it can suppress measles and identify rubella, and it would benefit from the newer, more expensive vaccine.

The dual vaccine costs twice as much — 52 cents a dose at Unicef prices, compared with 24 cents for measles alone. (The MMR vaccine that American children get, which also contains a vaccine against mumps, costs Unicef $1.)

More than 90 percent of Rwandan children now are vaccinated twice against measles, and cases have been near zero since 2007.

The tiny country, which was convulsed by Hutu-Tutsi genocide in 1994, is now leading the way in Africa in delivering medical care to its citizens, Ms. McNab said. Three years ago, it was the first African country to introduce shots against human papilloma virus, or HPV, which causes cervical cancer.

In wealthy countries, measles kills a small number of children — usually those whose parents decline vaccination. But in poor countries, measles is a major killer of malnourished infants. Around the world, the initiative estimates, about 158,000 children die of it each year, or about 430 a day.

Every year, an estimated 112,000 children, mostly in Africa, South Asia and the Pacific islands, are born with handicaps caused by their mothers’ rubella infection.

Thanks in part to the initiative — which until last year was known just as the Measles Initiative — measles deaths among children have declined 71 percent since 2000. The initiative is a partnership of many health agencies, vaccine companies, donors and others, but is led by the American Red Cross, the United Nations Foundation, the Centers for Disease Control and Prevention, Unicef and the World Health Organization.

This article has been revised to reflect the following correction:

Correction: February 27, 2013

An earlier version of this article misstated the source of the vaccine and some financing for the campaign. The vaccine and financing is being provided by the GAVI Alliance, not the Measles and Rubella Initiative.

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Island Air is Ellison's latest buy

How do you follow the purchase of an island in Hawaii?

If you're Oracle Chief Executive Larry Ellison, you buy an airline so you can hop to and from your tropical paradise.

Ellison has been on a shopping spree lately, buying 98% of the island of Lanai in June from Los Angeles billionaire David Murdock and then, in November, buying a beachfront Malibu home from film and TV producer Jerry Bruckheimer.

Ellison's most risky acquisition may be Island Air, which he bought Wednesday through a holding company.

The exact purchase prices of Ellison's recent deals have not been disclosed, but local observers value the 141-square-mile island at more than $500 million and the three-bedroom, three-bath Malibu pad at more than $3.65 million. The details of the airline deal were not announced.

Island Air, a regional carrier serving airports on all major Hawaiian islands, has 245 employees and three turboprop planes, with 224 weekly flights between the islands of Oahu, Maui, Molokai, Lanai and Kauai.

Lanai, the sixth-largest Hawaiian island, was once a pineapple plantation and is still sparsely inhabited. It includes two resort hotels and two golf courses with clubhouses, according to Hawaii's Public Utilities Commission.

But Ellison did not buy the airline just to get to and from his island, airline officials say.

He hopes to expand the businesses to serve locals visiting relatives on the islands and to fly mainland and foreign tourists throughout the island state, airline officials said. The airline plans to retire two 1980s-era planes and expand to four or five new ATR 72 turboprops by the end of the year.

But Ellison should not get his hopes up about pocketing big profits, said Ray Neidl, an aviation analyst for Nexa Capital Partners in Washington, D.C.

"It's a high-risk situation with no significant margins, at least initially," he said of owning an airline.

And if Ellison hopes to expand the business, he should expect to get some resistance from the big carrier on the island, Hawaiian Airlines, Neidl added. "It really depends on what Hawaiian does."

Island Air began in 1980 as Princeville Airways, carrying passengers from Kauai to Honolulu. The history of the carrier has not always been blue skies and soft landings.

"In our 30-plus years, we had our ups and downs, pardon the pun," said Michael Rodyniuk, a senior consultant to the airline.

Like most airlines across the country, he said, Island Air struggled during the economic turmoil between 2008 and 2012 but expects to thrive with a surge in tourism that Hawaii has been enjoying in the past year or so.

The state welcomed a record 8 million visitors in 2012, surpassing the previous high of 7.6 million visitors in 2006.

"All major markets are up," Rodyniuk said.

The previous owner of the airline, California businessman Charles Willis IV, had been looking for a buyer for the airline and had put all 245 employees on notice that layoffs could begin as soon as March 11 if a buyer was not found, he said. "So Mr. Ellison saved 245 jobs," Rodyniuk said.

Forbes ranks Ellison as the third-richest American, with a net worth of $36 billion. He has cut big checks in the past on high-priced properties in Malibu, Lake Tahoe, Rancho Mirage and other locations.

But unlike real estate, air carriers are an investment that can give investors nightmares.

Virgin America, a California-based airline partly owned by millionaire Richard Branson, has been operating for more than five years without recording a profitable year.

California Pacific Airlines is the brainchild of Encinitas businessman Ted Vallas, who has already invested more than $6 million of his own money but has spent the last year trying to clear federal red tape so he can begin selling tickets.

And then there are the 11 other airlines — including American, Delta, United and US Airways — that have filed for bankruptcy since 2000.

"The profit margins on airlines, even though they are improving, are not that attractive," Neidl said.

hugo.martin@latimes.com

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Tribune Co. hires advisors to explore sale of newspaper unit

Tribune Co. has hired investment bankers to advise the media company on the potential sale of its newspaper publishing unit.

The company announced that it has retained JPMorgan Chase & Co. and Evercore Partners to assess whether to sell the division that includes the Los Angeles Times, Chicago Tribune and six other daily newspapers.

The bankers will analyze bids from suitors, but their hiring does not necessarily mean that the assets would be sold.

"There is a lot of interest in our newspapers, which we haven't solicited," Gary Weitman, a Tribune spokesman, said in a statement. "Hiring outside financial advisors will help us determine whether that interest is credible, allow us to consider all of our options, and fulfill our fiduciary responsibility to our shareholders and employees."

Tribune hopes to sell the newspaper group intact instead of selling each paper individually, according to a person familiar with the matter.

The Chicago company has a healthy balance sheet and doesn't feel financial pressure to sell the properties, according to the person. It's unclear how long the process could take.

There has been widespread speculation that Tribune would attempt to unload the newspaper business to focus on its more promising television operations. Rupert Murdoch's News Corp. is among the possible bidders for the newspaper assets.

Tribune emerged from its four-year bankruptcy at the end of 2012 and appointed broadcasting veteran Peter Liguori as chief executive in January.

JPMorgan Chase holds an ownership stake in Tribune.

Evercore Partners, a boutique investment bank, also is working for the parent company of the New York Times on its planned divestiture of the Boston Globe.

walter.hamilton@latimes.com

andrew.tangel@latimes.com

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Bobby Brown sentenced to 55 days in jail for DUI

LOS ANGELES (AP) — Bobby Brown has been sentenced to 55 days in a Los Angeles jail and four years of probation for a drunken driving case.

City attorney's spokesman Frank Mateljan (mah-tell-JIN') says Brown was sentenced Tuesday after pleading no contest to charges he was under the influence and driving on a suspended license when he was arrested in October.

Brown was on probation for another DUI case at the time.

The 44-year-old "New Edition" singer was ordered to report to jail March 20. He also was placed on four years of informal probation and will be required to complete an 18-month alcohol treatment program.

Brown's attorney Tiffany Feder had no immediate comment on the sentence.

The sentence was first reported by celebrity website TMZ.

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Advanced Breast Cancer May Be Rising Among Young Women, Study Finds

The incidence of advanced breast cancer among younger women, ages 25 to 39, may have increased slightly over the last three decades, according to a study released Tuesday.

But more research is needed to verify the finding, which was based on an analysis of statistics, the study’s authors said. They do not know what may have caused the apparent increase.

Some outside experts questioned whether the increase was real, and expressed concerns that the report would frighten women needlessly.

The study, published in The Journal of the American Medical Association, found that advanced cases climbed to 2.9 per 100,000 younger women in 2009, from 1.53 per 100,000 women in 1976 — an increase of 1.37 cases per 100,000 women in 34 years. The totals were about 250 such cases per year in the mid-1970s, and more than 800 per year in 2009.

Though small, the increase was statistically significant, and the researchers said it was worrisome because it involved cancer that had already spread to organs like the liver or lungs by the time it was diagnosed, which greatly diminishes the odds of survival.

For now, the only advice the researchers can offer to young women is to see a doctor quickly if they notice lumps, pain or other changes in the breast, and not to assume that they cannot have breast cancer because they are young and healthy, or have no family history of the disease.

“Breast cancer can and does occur in younger women,” said Dr. Rebecca H. Johnson, the first author of the study and medical director of the adolescent and young adult oncology program at Seattle Children’s Hospital.

But Dr. Johnson noted that there is no evidence that screening helps younger women who have an average risk for the disease and no symptoms. “We’re certainly not advocating that young women get mammography at an earlier age than is generally specified,” she said.

Expert groups differ about when screening should begin; some say at age 40, others 50.

Breast cancer is not common in younger women; only 1.8 percent of all cases are diagnosed in women from 20 to 34, and 10 percent in women from 35 to 44. However, when it does occur, the disease tends to be more deadly in younger women than in older ones. Researchers are not sure why.

The researchers analyzed data from SEER, a program run by the National Cancer Institute to collect cancer statistics on 28 percent of the population of the United States. The study also used data from the past when SEER was smaller.

The study is based on information from 936,497 women who had breast cancer from 1976 to 2009. Of those, 53,502 were 25 to 39 years old, including 3,438 who had advanced breast cancer, also called metastatic or distant disease.

Younger women were the only ones in whom metastatic disease seemed to have increased, the researchers found.

Dr. Archie Bleyer, a clinical research professor in radiation medicine at the Knight Cancer Institute at the Oregon Health and Science University in Portland who helped write the study, said scientists needed to verify the increase in advanced breast cancer in young women in the United States and find out whether it is occurring in other developed Western countries. “This is the first report of this kind,” he said, adding that researchers had already asked colleagues in Canada to analyze data there.

“We need this to be sure ourselves about this potentially concerning, almost alarming trend,” Dr. Bleyer said. “Then and only then are we really worried about what is the cause, because we’ve got to be sure it’s real.”

Dr. Johnson said her own experience led her to look into the statistics on the disease in young women. She had breast cancer when she was 27; she is now 44. Over the years, friends and colleagues often referred young women with the disease to her for advice.

“It just struck me how many of those people there were,” she said.

Dr. Donald A. Berry, an expert on breast cancer data and a professor of biostatistics at the University of Texas’ M. D. Anderson Cancer Center in Houston, said he was dubious about the finding, even though it was statistically significant, because the size of the apparent increase was so small — 1.37 cases per 100,000 women, over the course of 30 years.

More screening and more precise tests to identify the stage of cancer at the time of diagnosis might account for the increase, he said.

“Not many women aged 25 to 39 get screened, but some do, but it only takes a few to account for a notable increase from one in 100,000,” Dr. Berry said.

Dr. Silvia C. Formenti, a breast cancer expert and the chairwoman of radiation oncology at New York University Langone Medical Center, questioned the study in part because although it found an increased incidence of advanced disease, it did not find the accompanying increase in deaths that would be expected.

A spokeswoman for an advocacy group for young women with breast cancer, Young Survival Coalition, said the organization also wondered whether improved diagnostic and staging tests might explain all or part of the increase.

“We’re looking at this data with caution,” said the spokeswoman, Michelle Esser. “We don’t want to invite panic or alarm.”

She said it was important to note that the findings applied only to women who had metastatic disease at the time of diagnosis, and did not imply that women who already had early-stage cancer faced an increased risk of advanced disease.

Dr. J. Leonard Lichtenfeld
, deputy chief medical officer of the American Cancer Society, said he and an epidemiologist for the society thought the increase was real.

“We want to make sure this is not oversold or that people suddenly get very frightened that we have a huge problem,” Dr. Lichtenfeld said. “We don’t. But we are concerned that over time, we might have a more serious problem than we have today.”

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Bernanke urges Congress to avoid spending cuts

WASHINGTON — Federal Reserve Chairman Ben S. Bernanke urged Congress to avert the new spending cuts set to begin Friday, saying they not only are bad for the economy but fail to deal with the underlying problems of the nation's long-term debt.

"You've made progress in the very near term as far as the budget is concerned," Bernanke told members of the Senate on Tuesday, referring to measures now in place that are expected to reduce the government's red ink for the next several years.

"Where the problem still remains unaddressed is in the longer term. And so it doesn't quite match to be doing tough policies today when the real problem is a somewhat longer-term problem."

QUIZ: Test your knowledge about the debt limit

At the same time, the Fed chief laid out a case for why the central bank should keep priming the economy with monetary stimulus — despite dissent from within and concerns from outside that the Fed's easy-money policies may be doing more harm than good.

Critics said the Fed was encouraging excessive risk-taking and sowing seeds of future inflation.

In his semiannual testimony to Congress on monetary policy and the economy, Bernanke said the Fed's bond-buying and other efforts to hold down interest rates had helped the housing market and car sales.

The Fed should continue those policies given the weak job market and low rate of inflation, he said, noting that he didn't see much evidence of a stock market bubble.

Diane Swonk, chief economist at Mesirow Financial in Chicago, said of Bernanke's testimony, "Those worried that the Fed may end large-scale asset purchases prematurely should be reassured."

Bernanke's remarks cheered Wall Street as investors and analysts concluded that the Fed's campaign to stimulate economic growth was unlikely to be slowed or halted any time soon.

The Dow Jones industrial average rose 115.96 points, or 0.84%, to close at 13,900.13 on Tuesday. That recouped about half the losses the Dow suffered Monday after the Italian election results reignited worries about the Eurozone debt crisis and unsettled financial markets around the world.

Bernanke also pushed back against accusations that he was soft on inflation.

Responding to Sen. Bob Corker (R-Tenn.), who called Bernanke the "biggest dove" on inflation "since World War II," Bernanke said "my inflation record is the best of any Federal Reserve chairman in the postwar period, or at least one of the best, about 2% average inflation."

The record of the Bernanke years has been notably less stellar on unemployment. The Fed has a dual mandate — to control inflation and to maximize employment. Liberal critics have said Bernanke has done too little to stimulate the economy to bring unemployment down, even as conservatives have accused him of doing too much.

In his testimony, Bernanke repeated his oft-stated concerns about the hardships of millions of unemployed people, particularly those without work for more than six months. He also rebutted the complaint that the Fed's efforts to tackle the nation's high jobless rate have hurt savers, especially seniors, by keeping interest rates at record-low levels.

"The only way to get interest rates up for savers is to get a strong recovery. And the only way to get a strong recovery is to provide adequate support to the recovery," he said.

Right now, that recovery continues at a moderate pace, Bernanke said. He described the flattening of growth in the fourth quarter last year as a "pause" and said "available information suggests that economic growth has picked up again this year."

Although the Fed's stimulus programs drew considerable attention in the two-hour hearing, lawmakers were largely focused on their own problems, most notably the automatic spending cuts that are set to start taking effect Friday.

Several pressed Bernanke for his opinion on whether the economy would be better off with a more targeted round of budget cuts instead of the across-the-board effects of the so-called sequestration.

A more "thoughtful approach" would be better, Bernanke said. But he noted that in the short term, the "effect on growth would probably not be substantially different" if smarter budget cuts were put in place.

The basic problem is that any cut the size of the one planned — about $85 billion this year — probably would reduce economic growth, Bernanke said. He agreed with the Congressional Budget Office's estimate that the budget cuts would slice a sizable 0.6 percentage point from economic growth this year.

Combined with other deficit-reduction policies that already have been put into place, the budget changes are likely to slow economic growth by 1.5 percentage points this year, a significant figure given that the economy has been growing on average just over 2% a year.

"I am not in any way denying the importance of long-run fiscal stability," Bernanke said. "I just think that to some extent, the fiscal policy decisions being made are mismatched with the timing of the problem. The problem is a longer-term problem and should be addressed over a longer time frame."

don.lee@latimes.com

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Bill would bar some athletes from California workers' comp claims

SACRAMENTO — Players for professional sports teams based outside of California would be barred from filing compensation claims for job-related injuries under proposed legislation supported by owners of football, baseball, basketball, hockey and soccer franchises.

A bill unveiled Monday by Assembly Insurance Committee Chairman Henry Perea (D-Fresno) would ban retired athletes from seeking workers' compensation benefits from California courts after they've played relatively few games in California stadiums and arenas during their careers.

The proposal, AB 1309, is expected to be one of the most hotly debated issues of the legislative session, with team owners lining up against the players' unions and their labor allies.

The bill, said Perea, is expected to be a "starting point" for a lively legislative debate over whether claims from out-of-state retired players represent abuse of the California workers' compensation system and wind up hitting all California employers with higher premiums and surcharges that pay for outstanding claims left by failed insurance companies.

"It's a question of fairness," Perea said.

Workers' compensation is 100% employer funded and does not depend on taxpayers' support.

The cost argument is phony, countered Richard Berthelsen, a consulting lawyer with the National Football League Players Assn. A prorated share of a team's workers' compensation bill is calculated into athletes' salary caps, so, in effect, they're paying for their own insurance coverage, Berthelsen contended. "They pay for their own benefits," he said.

Perea's bill would affect professional athletes from only the five big sports and not members of other professions whose work takes them from state to state, such as horse racing jockeys, truck drivers and salesmen. It would bar the filing of claims for cumulative trauma — caused by years of stress and pounding on a body rather than a broken bone or other specific injury — unless a player worked at least 90 days in California during the year prior to seeking benefits.

California is the only state that makes it relatively easy for long-retired players to claim cumulative trauma injuries. About 4,500 out-of-state players have won judgments or settlements since the early 1980s, according to a study commissioned by the professional sports leagues.

The bill, if it should become law, would apply to thousands of out-of-state athletes' claims currently pending before California workers' compensation judges.

Perea's legislation, by restricting benefits only for professional athletes, is potentially unfair, labor officials argued.

Regardless of whether they play for out-of-state teams, said Angie Wei, legislative director of the California Labor Federation, "these players are workers and they deserve to have access to their benefits. They work for short durations of time at an intense level and get injured."

marc.lifsher@latimes.com

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Singer Morrissey says no to Kimmel, 'Duck Dynasty'

LOS ANGELES (AP) — The TV series "Duck Dynasty" is coming between Morrissey and Jimmy Kimmel.

The singer and animal rights activist says he canceled his appearance Tuesday on ABC's "Jimmy Kimmel Live" because "Duck Dynasty" cast members will be on the talk show.

Morrissey says he can't perform on a show with what he called people who "amount to animal serial killers."

A&E's "Duck Dynasty" reality show follows a Louisiana family with a business selling duck calls and decoys.

A&E did not immediately respond to requests for comment from it and the Robertson family.

A person familiar with the Kimmel show's plans confirmed that Morrissey was to appear. The person lacked authority to discuss the matter publicly and spoke on condition of anonymity.

The person says Morrissey's performance will be rescheduled.

ABC says the Churchill band will perform Tuesday on Kimmel's show but declined comment on the switch.

___

Reach AP Television Writer Lynn Elber at http://www.twitter.com/lynnelber .

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Global Health: After Measles Success, Rwanda to Get Rubella Vaccine

Rwanda has been so successful at fighting measles that next month it will be the first country to get donor support to move to the next stage — fighting rubella too.

On March 11, it will hold a nationwide three-day vaccination campaign with a combined measles-rubella vaccine, hoping to reach nearly five million children up to age 14. It will then integrate the dual vaccine into its national health service.

Rwanda can do so “because they’ve done such a good job on measles,” said Christine McNab, a spokeswoman for the Measles and Rubella Initiative, which will provide the vaccine and help pay for the campaign.

Rubella, also called German measles, causes a rash that is very similar to the measles rash, making it hard for health workers to tell the difference.

Rubella is generally mild, even in children, but in pregnant women, it can kill the fetus or cause serious birth defects, including blindness, deafness, mental retardation and chronic heart damage.

Ms. McNab said that Rwanda had proved that it can suppress measles and identify rubella, and it would benefit from the newer, more expensive vaccine.

The dual vaccine costs twice as much — 52 cents a dose at Unicef prices, compared with 24 cents for measles alone. (The MMR vaccine that American children get, which also contains a vaccine against mumps, costs Unicef $1.)

More than 90 percent of Rwandan children now are vaccinated twice against measles, and cases have been near zero since 2007.

The tiny country, which was convulsed by Hutu-Tutsi genocide in 1994, is now leading the way in Africa in delivering medical care to its citizens, Ms. McNab said. Three years ago, it was the first African country to introduce shots against human papilloma virus, or HPV, which causes cervical cancer.

In wealthy countries, measles kills a small number of children — usually those whose parents decline vaccination. But in poor countries, measles is a major killer of malnourished infants. Around the world, the initiative estimates, about 158,000 children die of it each year, or about 430 a day.

Every year, an estimated 112,000 children, mostly in Africa, South Asia and the Pacific islands, are born with handicaps caused by their mothers’ rubella infection.

Thanks in part to the initiative — which until last year was known just as the Measles Initiative — measles deaths among children have declined 71 percent since 2000. The initiative is a partnership of many health agencies, vaccine companies, donors and others, but is led by the American Red Cross, the United Nations Foundation, the Centers for Disease Control and Prevention, Unicef and the World Health Organization.

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Bill would bar some athletes from California workers' comp claims

SACRAMENTO — Players for professional sports teams based outside of California would be barred from filing compensation claims for job-related injuries under proposed legislation supported by owners of football, baseball, basketball, hockey and soccer franchises.

A bill unveiled Monday by Assembly Insurance Committee Chairman Henry Perea (D-Fresno) would ban retired athletes from seeking workers' compensation benefits from California courts after they've played relatively few games in California stadiums and arenas during their careers.

The proposal, AB 1309, is expected to be one of the most hotly debated issues of the legislative session, with team owners lining up against the players' unions and their labor allies.

The bill, said Perea, is expected to be a "starting point" for a lively legislative debate over whether claims from out-of-state retired players represent abuse of the California workers' compensation system and wind up hitting all California employers with higher premiums and surcharges that pay for outstanding claims left by failed insurance companies.

"It's a question of fairness," Perea said.

Workers' compensation is 100% employer funded and does not depend on taxpayers' support.

The cost argument is phony, countered Richard Berthelsen, a consulting lawyer with the National Football League Players Assn. A prorated share of a team's workers' compensation bill is calculated into athletes' salary caps, so, in effect, they're paying for their own insurance coverage, Berthelsen contended. "They pay for their own benefits," he said.

Perea's bill would affect professional athletes from only the five big sports and not members of other professions whose work takes them from state to state, such as horse racing jockeys, truck drivers and salesmen. It would bar the filing of claims for cumulative trauma — caused by years of stress and pounding on a body rather than a broken bone or other specific injury — unless a player worked at least 90 days in California during the year prior to seeking benefits.

California is the only state that makes it relatively easy for long-retired players to claim cumulative trauma injuries. About 4,500 out-of-state players have won judgments or settlements since the early 1980s, according to a study commissioned by the professional sports leagues.

The bill, if it should become law, would apply to thousands of out-of-state athletes' claims currently pending before California workers' compensation judges.

Perea's legislation, by restricting benefits only for professional athletes, is potentially unfair, labor officials argued.

Regardless of whether they play for out-of-state teams, said Angie Wei, legislative director of the California Labor Federation, "these players are workers and they deserve to have access to their benefits. They work for short durations of time at an intense level and get injured."

marc.lifsher@latimes.com

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