MONDAY, May 20 (HealthDay News) -- A child whose mother lived near heavy traffic while pregnant faces a relatively higher risk for developing a respiratory infection before the age of 3, a new study suggests.

Researchers looked at data involving nearly 1,300 pairs of mothers and infants from eastern Massachusetts. All the mothers began study participation while in their first trimester of pregnancy at some point between 1999 and 2002.

About 6 percent of the mothers lived within 100 meters (about 110 yards) from a major roadway, while another 7 percent lived between 100 and 200 meters away. About one-third of the mothers lived from 200 to 1,000 meters (about two-fifths of a mile) away, while the rest lived 1,000 meters or more from a major roadway.

Among their infants, about 53 percent had suffered at least one diagnosed respiratory infection, including pneumonia, bronchiolitis or croup by age 3.

Offspring of mothers living the shortest distance from a major roadway had a 1.74 times greater risk for such infections compared to those living farthest away. Those whose mothers lived 100 to 200 meters from a roadway had a 1.49 greater risk.

The findings held true even after adjusting for a range of factors, including maternal smoking during pregnancy, postnatal household smoking, breastfeeding, daycare attendance, presence of other young children in the household and season of birth.

"The connection between in utero and early life cigarette smoke exposure and adverse infant respiratory outcomes is well-established, but the relation of prenatal ambient air pollution to risk of infant respiratory infection is less well-studied," study author Dr. Mary Rice said in an American Thoracic Society news release.

Rice, a pulmonary and critical care fellow at Massachusetts General Hospital and Beth Israel Deaconess Medical Center, and colleagues are scheduled to present their findings this week at an American Thoracic Society meeting in Philadelphia.

Studies presented at medical meetings should be considered preliminary until published in a peer-reviewed journal. The new study found a link between exposure to heavy traffic in pregnancy and respiratory illness in children, but it didn't prove cause-and-effect.

More information

For more on air pollution and infants, visit the March of Dimes.

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FRIDAY, May 17 (HealthDay News) -- Liver transplants to treat a common type of liver cancer are a viable option for people infected with HIV, according to new research.

The Italian study, published May 10 in the journal The Oncologist, found that the AIDS-causing virus doesn't affect survival rates and cancer recurrence after transplants among HIV patients with this particular type of liver cancer, called hepatocellular carcinoma (HCC). The study's authors noted, however, that HCC is more aggressive in people with HIV and it is becoming a major cause of death among these patients as antiretroviral treatment prolongs their lives.

"The key message of this study is that liver transplantation is a valid option for HCC treatment in HIV-infected patients," the study's authors wrote in a journal news release. "We suggest that HIV-infected patients must be offered the same liver transplant options for HCC treatment currently provided to HIV-uninfected subjects."

The study involved 30 HIV-positive patients and 125 patients not infected with HIV who received a liver transplant to treat HCC at three different hospitals in northern Italy between 2004 and 2009.

During a follow-up period of roughly 32 months, the researchers found a recurrence of HCC in 6.7 percent of the patients with HIV and 14.4 percent of the patients who were not HIV positive.

The study also revealed that survival was similar for all of the patients one year after surgery and three years post-surgery.

The researchers, led by Dr. Fabrizio Di Benedetto, associate professor of surgery at the University of Modena, said the HIV-positive patients were treated with antiretroviral therapy until they underwent the transplant. The therapy was not resumed until their liver function stabilized after surgery.

None of the HIV-positive patients developed AIDS during the post-surgery follow-up period. The study's authors suggested that this may be due to timely resumption of HIV therapy following the liver transplant.

New options in antiviral therapy for people with HIV could improve control of the HIV virus as well as outcomes following liver transplant for HCC, the researchers said.

Patients with HIV undergoing liver transplant for HCC would benefit most from a multidisciplinary approach to care, the study authors said, which would involve collaboration among oncologists, radiologists, gastroenterologists, liver surgeons and infectious disease specialists.

More information

The American Cancer Society provides more information on hepatocellular carcinoma.

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THURSDAY, May 16 (HealthDay News) -- The tainted steroid injections linked to 55 recent U.S. deaths also caused many less lethal infections, more than half of them concentrated in Michigan, federal health officials reported Thursday.

Spinal meningitis deaths caused by contaminated back-pain treatments made the news for weeks last fall. But less attention was paid to a host of spinal or near-spinal infections without meningitis that were reported later in the outbreak. As of the first week of May, they had affected 320 people nationwide, with 52 percent of those cases in Michigan.

"Michigan has reported the highest percentage of cases even though we received only 13 percent of the contaminated drug that was shipped nationally," the report's co-author, Mawuli Nyaku, epidemic intelligence service officer at the U.S. Centers for Disease Control and Prevention, said Thursday.

The reasons for that disproportionate rate aren't clear, Nyaku said. Nor is it known if more cases will surface.

"We are not out of the woods yet," Nyaku said. "We have never seen anything like this before."

Because the time from injection to symptoms of illness isn't really known, more people who received the tainted drug may develop infections, Nyaku said. "Physicians are seeing patients who have developed infections 200 days after receipt of injection," he said. He urged doctors to consider the possibility of infection in anyone who received the epidural injections.

The infections -- whether leading to meningitis or not -- are caused by a fungus called Exserohilum rostratum (basically a common black mold) that contaminated vials of steroids produced by the now-shuttered New England Compounding Center in Massachusetts.

Since first reported last September, the outbreak has sickened 741 people in 20 states and killed 55. In Michigan, 261 people developed infections and 16 died, according to the report, which was published in the May 17 issue of the CDC's Morbidity and Mortality Weekly Report.

The localized infections, concentrated at or near the injection site, have led to abscesses, pain and some joint infections that necessitated joint replacement, Nyaku said.

These infections caught experts by surprise.

"We have known that the predominating organism was Exserohilum rostratum, which is a fungus," said Dr. Marc Siegel, an associate professor of medicine at NYU Langone Medical Center in New York City. "What we didn't know was that there were a series of spinal infections without meningitis."

Nyaku said one reason for the high number of cases in Michigan is that St. Joseph Mercy Hospital in Ann Arbor saw the most patients with the infection in the country. To help identify new cases, the hospital offered MRIs to anybody who had been exposed to the contaminated steroids. "In doing so they identified additional cases, which contributed to the high number," Nyaku said.

Another possible explanation, Nyaku said, is that more than 2,000 of the 17,000 vials of tainted drugs were shipped to Michigan. And one of the lots shipped to the state appeared to cause more infections than the other two contaminated lots, he said.

The black mold infections continue to bedevil investigators. No foolproof cure exists, and the drugs used to treat the infection are very expensive and can be toxic, he said. "When you put a patient on therapy, there isn't a guarantee that he is going to get better," Nyaku said.

Some patients who stopped therapy also have seen their illness return, he said.

More information

For more information on fungal infections, visit the U.S. Centers for Disease Control and Prevention.

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THURSDAY, May 16 (HealthDay News) -- For those who aren't born with long, fluttery eyelashes, cosmetic extensions can help achieve that often sought-after look. But eye experts warn that the adhesives used to apply these eyelash extensions can cause allergies and infections.

The American Academy of Ophthalmology (AAO) warns that among the potential dangers associated with cosmetic eyelash extensions and the adhesives used to apply them are infections of the cornea and eyelid, permanent or temporary loss of eyelashes, and eyelid swelling.

The academy said that a recent Consumer Reports article details the cases of several patients who suffered infections and allergic reactions to formaldehyde-based adhesives used with eyelash extensions.

The AAO said consumers should use caution if they're considering eyelash extensions and offered the following advice:

• Only go to an aesthetician who is certified and working at a reputable business.
• Ensure that adequate hand washing and proper hygiene is practiced by the aesthetician.
• Ask about the eyelash adhesive ingredients before getting the extensions applied.

People who develop an infection, allergic reaction or other irritation after using eyelash extensions or other eye products should immediately seek medical attention from an ophthalmologist -- a doctor who specializes in the treatment of eye conditions, the experts noted in an AAO news release.

More information

The U.S. Food and Drug Administration offers tips for the safe use of eye cosmetics.

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THURSDAY, May 16 (HealthDay News) -- There are few things more inviting than a cool, clear pool on a hot summer day. But a new federal report will have you thinking twice before dipping a toe in the water.

Fifty-eight percent of pool filter samples taken from Atlanta area pools last summer contained E. coli, a bacteria found in human feces.

The report is a sign that swimmers often contaminate pool water when they have a "fecal incident" in the water, or when human waste washes off their bodies because they don't shower thoroughly before hitting the water, according to the report from the U.S. Centers for Disease Control and Prevention.

And while the study only focused on pools in the Atlanta region, the researchers said it's likely that fecal contamination from swimmers is a problem in public pools throughout the country. The study did not look at water parks, residential pools or other types of recreational water.

"Swimming is an excellent way to get the physical activity needed to stay healthy," Michele Hlavsa, chief of the CDC's Healthy Swimming Program, said in an agency news release. "However, pool users should be aware of how to prevent infections while swimming.

"Remember," she added, "chlorine and other disinfectants don't kill germs instantly. That's why it's important for swimmers to protect themselves by not swallowing the water they swim in and to protect others by keeping feces and germs out of the pool by taking a pre-swim shower and not swimming when ill with diarrhea.

The CDC says all swimmers should take the following steps to keep feces out of pools and to prevent infections:

• Don't swim if you have diarrhea.
• Shower with soap before swimming.
• Take a rinse shower before getting back in the water.
• Go to the bathroom every 60 minutes.
• Wash your hands with soap after using the toilet or changing diapers.
• Don't swallow the water you swim in.

Parents of young children should take the following steps:

• Take children on bathroom breaks every 60 minutes or check diapers every 30 to 60 minutes.
• Change diapers in the bathroom or diaper-changing area and not at poolside where germs can rinse into the water.

Dr. Robert Glatter, an emergency medicine physician at Lenox Hill Hospital in New York City, said the new study "highlights the importance of practicing good hygiene anytime we swim in a pool, since the potential for contamination with fecal organisms, which could lead to severe diarrheal illnesses, remains an ever present concern.

"From a public health standpoint," he added, "it is especially important for people to avoid swimming when they have diarrhea, as other swimmers could swallow germ-laden water and potentially become ill.

The study reveals a "true public health concern, and reinforces the need to practice safe and effective swim hygiene as the summer approaches," Glatter said.

The study appears in the May 17 issue of the CDC's Morbidity and Mortality Weekly Report. Its release is timed in advance of Recreational Water Illness and Injury Prevention Week, May 20-26. The goal of the prevention week is to "raise awareness about healthy swimming, including ways to prevent recreational water illnesses (RWIs). Germs that cause RWIs are spread by swallowing, breathing in the mists or aerosols from, or having contact with contaminated water in swimming pools, water parks, hot tubs, interactive fountains, water play areas, lakes, rivers, or oceans," according to the CDC.

More information

For more on healthy swimming visit the U.S. Centers for Disease Control and Prevention.

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THURSDAY, May 16 (HealthDay News) -- Flu-causing H1N1 virus has been discovered in marine animals -- specifically seals -- for the first time.

After the human H1N1 influenza pandemic began in 2009, researchers from the University of California, Davis, detected the virus in free-ranging northern elephant seals off the central California coastline.

"We thought we might find influenza viruses, which have been found before in marine mammals, but we did not expect to find pandemic H1N1," study lead author Tracey Goldstein, an associate professor with the university's One Health Institute and Wildlife Health Center, said in a university news release. "This shows influenza viruses can move among species."

The H1N1 virus originated in pigs, and the resulting infection was known as swine flu.

"The study of influenza virus infections in unusual hosts, such as elephant seals, is likely to provide us with clues to understand the ability of influenza virus to jump from one host to another and initiate pandemics," Adolfo Garcia-Sastre, director of the Global Health and Emerging Pathogens Institute at the Icahn School of Medicine at Mount Sinai, in New York City, said in the news release.

The new findings were published May 15 in the journal PLoS ONE.

In conducting the study, the researchers tested nasal swabs from more than 900 marine mammals from 10 different species off the Pacific Coast from Alaska to California between 2009 and 2011.

The H1N1 virus was identified in two northern elephant seals. Despite being infected with the virus, neither seal had any symptoms. Antibodies to the virus also were detected in 28 other elephant seals, suggesting exposure to the virus was widespread.

"H1N1 was circulating in humans in 2009," Goldstein said. "The seals on land in early 2010 tested negative before they went to sea, but when they returned from sea in spring 2010, they tested positive. So the question is: Where did it come from?"

The infected seals were tracked by satellite. The researchers said exposure to H1N1 likely occurred while the seals were at sea foraging in the northeast Pacific Ocean off the continental shelf.

Since marine animals could be infected with H1N1 without showing any signs that they are sick, the researchers said their findings are particularly important for people who work with or handle marine animals. Taking precautions, such as wearing gloves, when working with these animals can help prevent the spread of disease both to and from humans, Goldstein said.

Today, the World Health Organization reports that H1N1 is under control and behaves as a seasonal virus.

More information

Visit the U.S. Department of Health and Human Services to learn more about H1N1.

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TUESDAY, May 14 (HealthDay News) -- Dialysis facilities could cut bloodstream infection rates among their patients by up to half by following a set of recommendations from the U.S. Centers for Disease Control and Prevention, according to new research.

The CDC suggested that adopting their protocols could save lives and reduce health care costs.

"Dialysis patients often have multiple health concerns, and the last thing they need is a bloodstream infection from dialysis," CDC director Dr. Tom Frieden said in an agency news release. "These infections are preventable. CDC has simple tools that dialysis facilities can use to help ensure patients have access to the safe health care they deserve."

In 2010 alone, more than 380,000 people in the United States required hemodialysis for end-stage kidney disease. In the majority of patients, this treatment is started with a central line, which is a tube that a doctor usually places in a large vein in the neck or chest. The researchers noted, however, if a central line is not placed correctly or kept clean, it can provide a portal for germs to infect the body and the blood.

Although other forms of vascular access used for hemodialysis -- such as arteriovenous fistulas and grafts -- are less risky than central lines, they can also result in bloodstream infections, the experts noted.

Over the past two decades, the rate of hospitalization for bloodstream infections has increased 51 percent. The researchers pointed out that dialysis patients are more than 100 times more likely to get a potentially deadly bloodstream infection from a common resistant bacteria, methicillin-resistant Staphylococcus aureus.

To address this growing public health issue, in April 2009, the CDC invited outpatient dialysis centers to participate in a collaborative project aimed at preventing bloodstream infections among dialysis patients.

Among the CDC's guidelines:

• Use the skin antiseptic chlorhexidine for catheter exit-site care.
• Conduct staff training and competency assessments, specifically on catheter care and aseptic technique.
• Perform hand hygiene and vascular access care audits.
• Provide feedback to staff on infection and adherence rates.
• Use antimicrobial ointment on central line exit sites

In conducting the study, researchers analyzed data compiled from 17 outpatient dialysis facilities by the National Healthcare Safety Network. The investigators compared infection rates before and after a set of protocols from the CDC were consistently used.

Following the CDC protocols resulted in a 32 percent reduction in overall bloodstream infections and a 54 percent decrease in vascular access-related bloodstream infections (those related to devices used to access the bloodstream for hemodialysis).

"Dialysis patients are particularly vulnerable to infections," Dr. Priti Patel, head of CDC's dialysis safety efforts, said in the CDC news release. "We now know it is possible to significantly reduce the infections among dialysis patients by following CDC's checklists and tools. If all dialysis facilities nationwide were using the CDC interventions, we could see dramatic reductions in infections and adverse outcomes in this population."

Roughly 37,000 bloodstream infections develop each year among dialysis patients with central lines. It's estimated these infections cost $23,000 per hospitalization.

The U.S. Department of Health and Human Services has made the prevention of bloodstream infections among dialysis patients a national priority. The dialysis facilities involved in the study tracked the bloodstream infections that developed in their patients. The data compiled in the CDC's National Healthcare Safety Network is now also used by more than 5,000 dialysis facilities nationwide to track and prevent health care-related infections.

The CDC's guidelines can be implemented in dialysis facilities through a series of checklists and using audit tools available on the CDC's website. The CDC also offers a one-hour online training course on infection prevention for dialysis nurses and technicians. This course also offers continuing education credits.

The study was published in the current issue of the American Journal of Kidney Diseases.

More information

The U.S. National Library of Medicine has more about dialysis.

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WEDNESDAY, May 8 (HealthDay News) -- Women who come down with the flu during pregnancy may be at increased risk of having a child who develops bipolar disorder, a new study suggests.

The chance of a child eventually developing the mental health disorder was nearly four times higher when comparing mothers-to-be who had the flu to those who didn't, the researchers reported.

"We don't fully understand this," said study co-author Dr. Alan Brown. "The best guess is it's an inflammatory response. It could also be a result of fever," he noted.

"Mothers should stay away from people who have the flu," said Brown, a professor of clinical psychiatry and clinical epidemiology at the Columbia University College of Physicians and Surgeons in New York City.

However, he added, regarding the new findings, "women should not be greatly concerned, because a fourfold increase is pretty high from an epidemiological standpoint, but still the vast majority of the offspring did not get bipolar disorder."

Brown explained that "the risk of bipolar disorder in the population is about 1 percent, so if it's increased fourfold that would make it a 4 percent risk." Moreover, the researchers only looked at one risk factor for bipolar disorder, not all risk factors, which could skew these results, he noted.

The report was published in the May 8 online edition of JAMA Psychiatry.

Bipolar disorder, also called manic-depressive illness, causes unusual shifts in mood, energy, activity levels and the ability to carry out routine tasks. Bipolar disorder can be treated, and people with this illness can lead full and productive lives, according to the U.S. National Institute of Mental Health.

The condition often develops in the late teens or early adult years. Some people have their first symptoms during childhood, while others may develop symptoms as adults, the agency noted.

For the study, researchers at Columbia University and Kaiser Permanente identified cases of bipolar disorder by database linkages of a Northern California health plan and a county health care system, along with data from a mailed survey.

Participants were mothers who gave birth between 1959 and 1966 and their offspring. Researchers found 92 cases of bipolar disorder and compared them with 722 people matched in terms of occurrence of maternal influenza during pregnancy.

While the new study found an association of pregnant women getting the flu and a higher risk of bipolar disorder in their offspring, it didn't establish a cause-and-effect relationship.

"There is no understanding of the causal factors of this," said Dr. Alan Manevitz, a clinical psychiatrist at Lenox Hill Hospital in New York City. He was not involved with the study.

"Pregnancy itself puts extra stress on women in general," he pointed out. "Pregnancy also affects the immune system and increases the risk of getting the flu."

Flu during pregnancy increases the risk of miscarriage, premature birth and low birth weight infants, Manevitz said.

Pregnant women should get a flu shot, both Manevitz and Brown suggested.

Other studies have shown a similar association between flu during pregnancy and the child's risk for autism and schizophrenia -- now there is this association with bipolar disorder, Manevitz said. "This doesn't give us any causal connection," he emphasized.

More information

To learn more about bipolar disorder, visit the U.S. National Institute of Mental Health.

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WEDNESDAY, May 8 (HealthDay News) -- Women suffering from recurring urinary tract infections may carry a particularly hearty strain of E. coli bacteria that flourishes in both the gut and the bladder, and can migrate back and forth despite repeated treatments, a small new study finds.

Doctors believe that urinary tract infections are often caused by E. coli migrating from the gut to the urinary tract, according to study background information. But they have assumed that when the bacteria moves to the bladder, it loses its ability to flourish in the gastrointestinal tract.

Now the research published May 8 in the journal Science Translational Medicine suggests some strains of E. coli may be more adaptable than previously thought.

While studying a group of women who suffered from repeated episodes of urinary tract infection, the multinational team of researchers discovered strains of E. coli that can live and flourish in both the gut and the bladder.

"The idea was the ability to effectively colonize the urinary tract was inversely correlated to the ability to effectively colonize the [gastrointestinal] tract," said Michael Hibbing, a microbiologist with Washington University in St. Louis and study co-author. "We found that dichotomy wasn't necessarily true. We found one strain of E. coli that is very good at colonizing both the GI tract and the urinary tract."

More than half of all women develop at least one urinary tract infection during their lifetimes, according to the study. Up to a quarter of all women have experienced recurrent urinary tract infections -- two or more episodes within a six-month period.

The team uncovered the adaptable E. coli strains while studying 45 strains of the bacteria taken from the feces and urine of four otherwise healthy women who were experiencing successive urinary tract infection episodes.

The investigators found that two of the women were playing host to a dominant strain of E. coli that thrived in both the gut and the urinary tract during three urinary tract infections that occurred over the course of several months.

In the other two women, researchers found that the E. coli strain present in their gut and bladder changed as the patients suffered recurring urinary tract infection. The strain that caused the initial infection ended up replaced by a stronger strain that fared even better in both the urinary tract and gastrointestinal tract.

This opens the possibility that treating recurrent urinary tract infections may be more complex than previously thought, because bacteria causing the infections can move freely between the bladder and the gut, the study authors concluded.

"This is a nice high-quality piece of research that is really going to help us broaden the ideas we have about how women get and carry urinary tract infections," said Dr. Linda Brubaker, a urogynecologist and dean of the Loyola University Chicago Stritch School of Medicine. She was not involved with the new study.

"It opens the possibility that bacteria interact with each other, and depending on how the bacteria interact may determine whether a woman gets a single or recurring urinary tract infection," she said. "The solution is probably not going to be more antibiotics, but a deeper understanding of a specific woman's risk based on the bacteria that live in her bladder or her bowel."

Another expert discussed implications of the new findings.

By better understanding the bacterial environments of the gut and bladder, doctors will be able to craft cunning treatments for suffering women, said Dr. Dee Fenner, a professor of obstetrics, gynecology and urology at the University of Michigan School of Medicine.

"I think this will open up new treatment analysis. We'll start looking at [urinary tract infections] in a much different way," Fenner said, suggesting researchers may be able to clear up recurring urinary tract infections through the use of more targeted antibiotics or by even transplanting bacteria into the gut to try and crowd out the bad E. coli with a healthier strain.

More information

The American Academy of Family Physicians has more about urinary tract infections.

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WEDNESDAY, May 8 (HealthDay News) -- A specialized kind of immune cell that patrols the skin of people infected with the herpes virus appears to prevent the outbreak of painful sores, a new study suggests.

Researchers think the cells may be key to developing a potential vaccine against genital herpes, which afflicts more than 24 million people in the United States, according to the U.S. Centers for Disease Control and Prevention.

For the study, published online May 8 in the journal Nature, researchers took skin samples from people infected with HSV-2, the virus that causes genital herpes, and followed them as they healed from recent outbreaks.

Working with a high-powered microscope, researchers used fluorescent stains to find and label different types of immune cells in the skin. They were most interested in cells called CD8 killer T-cells.

Unlike antibodies, which bind to bacteria and viruses, preventing them from infecting cells in the first place, CD8 cells are a second line of defense, said Bryan Cullen, director of the Center for Virology at Duke University, in Durham, N.C.

"They kill virus-infected cells as quickly as possible after they become infected," said Cullen, who also studies herpes infections but was not involved in the research. Killing infected cells prevents them from becoming factories that crank out more copies of the virus, he said.

Scientists once thought that all CD8 cells roamed the body, looking for infected cells through the bloodstream.

By watching the immune response as it unfolded in the skin, researchers realized that there were special CD8 cells that stayed in place, patrolling the area around nerve endings like beat cops. They guessed that the cells were waiting for the herpes virus to emerge and cause trouble.

To test that theory, they used very fine lasers to pluck out these specialized cells to see what kinds of proteins they were making.

In skin that had some shedding of the herpes virus, the specialized CD8 cells made a lot of perforin, a protein that penetrates membranes to kill cells. In skin with no active virus, the specialized CD8 cells didn't make any perforin, suggesting that the function of the cells is indeed to kill herpes-infected cells.

The specialized CD8 cells also made other proteins to summon backup cells to the site to help tamp down the attack. And they didn't seem to make chemical signals that sound the all-clear, a message to immune responders that it's time to leave the area, which may explain why they stick around in the skin.

"We actually showed they were a very unique population of cells," said study senior author Dr. Lawrence Corey, a virologist and president and director of the Fred Hutchinson Cancer Center in Seattle. "They can stay in the skin for extended periods of time, they appear to have memory, they appear to have the kind of markers that go in response to a specific infection."

He added that doctors once thought herpes, which lies dormant in nerve cells, would reawaken and travel up the nerve endings to the skin surface where it would cause painful sores, and that it would take a couple of days for the body to respond and fight off each new assault.

He said the new research shows that such outbreaks are the exception, rather than the rule. The specialized CD8 cells in the skin seem to do a pretty good job of keeping the virus under control.

"It seems to me that if we improve their job, and if we study them and ask the questions -- How do we give them more help? How do we make them live longer? How do we make them function better? How do we increase their number? -- we may be able to develop an effective herpes vaccine," Corey said.

A vaccine against herpes would be a significant achievement. Aside from abstinence, there's no surefire way to prevent herpes infections. Condoms can reduce the risk of transmission, although the virus can still be shed from skin areas that condoms don't cover.

Experts caution that although the new finding is promising, a vaccine is still likely to be a long way off.

"They have good correlative evidence" that the specialized CD8 cells in skin keep the virus at bay, Cullen said. He added, however, that the research doesn't prove that boosting these cells would prevent infections.

He said it will take many more studies to demonstrate that -- if, in fact, it's true.

"It's time to take it to the next level," Cullen said.

As for cold sores (or fever blisters) on the lips or around the mouth -- also caused by the herpes simplex virus -- the researchers said that although it seems logical that those same CD8 cells might be at work, they didn't analyze it in this study.

More information

To find out more about genital herpes, head to the U.S. Centers for Disease Control and Prevention.

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TUESDAY, May 7 (HealthDay News) -- Only about half of Americans who are infected with hepatitis C undergo follow-up testing to determine if they are still infected, federal officials reported Tuesday.

"Many people who test positive on an initial hepatitis C test are not receiving the necessary follow-up test to know if their body has cleared the virus or if they are still infected," Dr. Tom Frieden, director of the U.S. Centers for Disease Control and Prevention, said in an agency news release.

"Complete testing is critical to ensure that those who are infected receive the care and treatment for hepatitis C that they need in order to prevent liver cancer and other serious and potentially deadly health consequences," Frieden said.

A blood test, called an antibody test, is used to check if a person has ever been infected with hepatitis C. For people who have had a positive result, a follow-up test -- called an RNA test -- can determine if they are still infected so they can receive necessary care and treatment.

Some people's bodies can clear hepatitis C infection on their own, but about 80 percent of people with hepatitis C remain infected and can develop major health problems.

In this study, researchers analyzed data from eight regions across the United States. Only 51 percent of the hepatitis C patients reported in these regions had a follow-up test, according to the Vital Signs report from the CDC.

"Hepatitis C has few noticeable symptoms, and left undiagnosed it threatens the health of far too many Americans -- especially baby boomers," Dr. John Ward, director of the CDC's Division of Viral Hepatitis, said in the news release. "Identifying those who are currently infected is important because new effective treatments can cure the infection better than ever before, as well as eliminate the risk of transmission to others."

About 3 million Americans are infected with hepatitis C, and as many as 75 percent do not know they are infected. The study found that 67 percent of all reported cases of current hepatitis C infection were among baby boomers, which includes people born from 1945 through 1965.

All people born in the United States during those years should be tested for hepatitis C, the CDC advised. The agency also recommended testing for other people at increased risk, including injection-drug users and people who received blood transfusions or organ transplants before widespread screening of the blood supply began in 1992.

May is Hepatitis Awareness Month, and May 19 is National Hepatitis Testing Day.

More information

The U.S. National Institute of Allergy and Infectious Diseases has more about hepatitis C.

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TUESDAY, May 7 (HealthDay News) -- People who take certain types of antidepressants may be at higher risk for potentially deadly Clostridium difficile infection, a new study suggests.

This type of infection is one of the most common caught by hospital patients and causes more than 7,000 deaths each year in the United States. Several medications are thought to increase the risk for this infection, including antidepressants.

In this study, University of Michigan researchers examined C. difficile infection in people with and without depression, and found that those with major depression had a 36 percent higher risk than those without depression. Older, widowed people were 54 percent more likely to catch C. difficile than older married people. People who lived alone had a 25 percent higher risk than those who lived with others.

The researchers then investigated if there was a link between antidepressants and C. difficile infection. They found that only two -- Remeron (mirtazapine) and Prozac (fluoxetine) -- increased the risk, and that each drug doubled the risk.

The findings, published May 6 in the journal BMC Medicine, should improve identification and early treatment of C. difficile infection in people taking these antidepressants, the researchers said.

The reason for the increased risk of infection in people taking the antidepressants is unknown, and people who have been prescribed the drugs need to keep taking them unless their doctor tells them otherwise, the researchers said. The research showed an association between antidepressant use and increased risk of contracting the infection, but it did not prove a cause-and-effect link.

"Depression is common worldwide," study leader Dr. Mary Rogers said in a university news release. "We have long known that depression is associated with changes in the gastrointestinal system."

"The interaction between the brain and the gut, called the 'brain-gut axis,' is fascinating and deserves more study," Rogers said. "Our finding of a link between depression and Clostridium difficile should help us better identify those at risk of infection and perhaps encourage exploration of the underlying brain-gut mechanisms involved."

More information

The American Academy of Family Physicians has more about C. difficile infection.

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MONDAY, May 6 (HealthDay News) -- Yearly flu vaccinations are safe for children with inflammatory bowel disease, but too few of these youngsters get a flu shot because their parents worry about possible side effects, researchers report.

Not only does vaccination help protect against the flu, it may even reduce inflammatory bowel disease (IBD) symptoms, according to the study, which was published May 6 in the journal Pediatrics.

Children with inflammatory bowel disease, which includes Crohn's disease and ulcerative colitis, often experience chronic abdominal pain, diarrhea, joint pain and other symptoms.

The researchers looked at all children under age 19 diagnosed with IBD in Ontario, Canada, between 1999 and 2009. They found that about 25 percent of the IBD patients received a flu shot from a doctor or nurse practitioner and that these youngsters had no increase in IBD-related health issues after being vaccinated.

The patients actually had fewer IBD-related doctor visits after receiving a flu shot.

"There is no risk of IBD flare following influenza immunization," study lead author Dr. Eric Benchimol said in a Children's Hospital of Eastern Ontario news release. "In the years they were immunized, children with IBD had lower rates of IBD-related outpatient physician visits compared to years they were not immunized. This may indicate that receiving the influenza vaccine protects against having a flare of IBD, or at least prevents visits to doctors for IBD-related symptoms."

The study findings should reassure parents of children with IBD and improve flu vaccination rates among these children, the researchers said.

More information

The Nemours Foundation has more about inflammatory bowel disease and children.

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MONDAY, May 6 (HealthDay News) -- Pimples have long been the bane of teenage existence, but pediatricians say there is now enough evidence on effective treatments to put out the first guidelines on battling acne in children.

There is a range of medications that can clear up even severe cases of acne, according to the American Academy of Pediatrics (AAP). Writing in the May issue of its journal Pediatrics, the group throws its support behind new guidelines from the American Acne and Rosacea Society that detail how to treat acne in children and teens of all ages.

That "all ages" part is important because acne is becoming more and more common in pre-teens, too, said Dr. Lawrence Eichenfield, the lead author of the AAP report. One study of 9- and 10-year-old girls found that more than three-quarters had pimples.

It's thought that it may be because boys and girls are, on average, starting puberty earlier compared with past generations, said Eichenfield, a pediatric dermatologist at Rady Children's Hospital in San Diego.

According to the AAP, mild acne often can be tackled with over-the-counter fixes. Washes, lotions and other products containing benzoyl peroxide are the best studied, and the best place to start, the group said.

"It's a pretty effective agent, especially for mild acne," Eichenfield said. Benzoyl peroxide is also the most common ingredient in over-the-counter acne fighters. Another common one is salicylic acid, but there has not been much research on it. When it has been tested head-to-head against benzoyl peroxide, Eichenfield said, the latter has won out.

If over-the-counter products do not do the job, the next step could be topical retinoids -- prescription medications like Retin-A, Avita and Differin. They are vitamin A derivatives and work by speeding up skin cell turnover, which helps unclog pores.

The main side effects of all the topical treatments are skin irritation and dryness, the AAP said.

If the acne is moderate to severe, oral antibiotics could be added to the mix because bacteria that live on the skin play a role in acne. When pores become clogged with oil and skin cells, bacteria can grow in the pore and cause inflammation. Antibiotics help by killing bacteria and soothing inflammation.

But, Eichenfield said, "it's important to use antibiotics appropriately." One reason is because acne-causing bacteria have become less sensitive to common antibiotics in the past couple decades, due to widespread use of the drugs.

Another is that antibiotics can have side effects, such as stomach upset, dizziness and, in girls, yeast infections.

When acne is severe and other treatments have failed, the AAP said, doctors and parents might consider the prescription drug isotretinoin -- brand-names including Roaccutane (formerly known as Accutane) and Claravis.

The drug is very effective, but it can cause birth defects, so girls and women have to use birth control and get regular pregnancy tests if they go on the medication. Isotretinoin also has been linked to inflammatory bowel disease, depression and suicidal thoughts in some users -- although it's not clear the drug is to blame, the AAP said. (Severe acne itself can cause depression and suicidal thoughts, for example.)

Dr. David Pariser, a dermatologist not involved in the recommendations, said they are "based on sound evidence" and reflect the "best practices" in battling acne.

When should parents consider taking their child to a doctor for acne treatment? It depends on how severe the problem is, and how bothered the child is, said Pariser, who sits on the board of directors of the American Academy of Dermatology.

Some kids can deal with skin eruptions, but Pariser said he sees others who refuse to leave the house.

Both he and Eichenfield said it's important to dispel kids' (and sometimes parents') acne myths. "Acne is not caused by dirt or poor hygiene," Eichenfield said, and harshly scrubbing your face will probably make the situation worse.

It's best to wash your face gently twice a day, with a soap-free pH-balanced cleanser, the AAP said. Facial toners -- which commonly come in pre-packaged acne regimens -- can help clear away oil. But the group suggested going easy on toners, since they can irritate the skin.

And what about food? "The medical community has swung back and forth on that over the years," Pariser said. Years ago, people thought that certain foods, like chocolate, sugar and iodine, promoted breakouts, but studies starting in the late 1960s failed to confirm that.

"The idea that food plays a role became relegated to myth," Eichenfield said. But recently, he added, some researchers have been revisiting the issue. There is some evidence that a sugary diet may promote acne, for example. But for now, it's not clear whether any diet changes will actually help keep kids' skin clear, Eichenfield said.

The bottom line, he said, is that many treatment options are available. "There's no reason that children have to live with acne that is severe and troubling to them," he said.

More information

Learn more about acne from the U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases.

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SATURDAY, May 4 (HealthDay News) -- Parents often are advised to replace children's toothbrushes after they've had strep throat, but that might be misguided, a new study suggests.

"It is probably unnecessary to throw away your toothbrush after a diagnosis of strep throat," study co-author Dr. Judith Rowen, an associate professor of pediatrics at the University of Texas Medical Branch in Galveston, said in a news release from the American Academy of Pediatrics (AAP).

Rowen's team presented the findings Saturday at the Pediatric Academic Societies annual meeting in Washington, D.C.

In the study, Rowen and colleagues first tried to grow group A Streptococcus -- the bacteria that causes strep throat -- on toothbrushes that had already been exposed to the bacteria in the laboratory, but had not been used by children. The germ grew and remained on the toothbrushes for at least 48 hours.

The team then tested whether the strep bug would grow on new toothbrushes used by 14 children who had strep throat. The children brushed their teeth for one minute and the toothbrushes were then placed in a sterile cover and taken to a lab where they were tested for the bacterium.

These toothbrushes were compared to toothbrushes used by 13 patients with sore throats that weren't strep throat and 27 healthy young people.

The researchers reported that the strep germ grew on only one of the 56 used toothbrushes, and that toothbrush had been used by someone without strep throat. Although the other toothbrushes did not grow the strep bacteria, they did grow other bacteria that are common in the mouth, the researchers said.

They cautioned that larger studies need to be conducted to confirm that the strep pathogen does not grow on toothbrushes used by children with strep throat.

Studies presented at medical meetings typically are considered preliminary until published in a peer-reviewed journal.

More information

The U.S. National Institute of Allergy and Infectious Diseases has more about strep throat.

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THURSDAY, May 2 (HealthDay News) -- Spring and summer send lots of people outdoors to enjoy the warm weather, but experts say that also brings an increase in cuts, scrapes and puncture wounds.

In the event of these types of injuries, doctors from Wake Forest Baptist Medical Center advised the first step to take is to assess if the wound is serious. Taking immediate action can help injuries heal faster and prevent infection. They noted, however, most often these injuries will not require a trip to the emergency department.

"There's definitely an increase in these types of injuries at this time of year," Dr. James Guerrini, medical director of Wake Forest Baptist Health Urgent Care, said in a medical center news release. "Fortunately, most of them are minor and can be treated effectively at home."

Simple first-aid is often enough to treat cuts and scrapes from outdoor activities. When treating a minor wound, the American College of Emergency Physicians offers the following tips:

• Thoroughly wash your hands with soap and warm water or use an antibacterial cleanser.
• Apply direct pressure with a clean cloth, paper towel or piece of gauze to the injured area to stop the bleeding.
• Clean the wound with cool water and mild soap, and gently dry the area.
• Apply an antibiotic ointment to the wound to reduce the risk for infection.
• Cover the wound with a sterile bandage.

"Cuts and scrapes are common, so everybody should know how to deal with them," Guerrini added. "Proper treatment administered quickly can prevent infection, promote healing and otherwise keep something minor from becoming something major."

In some cases, however, emergency medical attention is required. The U.S. National Institutes of Health advised seeking urgent care for the following:

• Wounds that are very large or bleeding excessively.
• Injuries that are on the face or near a bone.
• Injuries that have caused people to lose feeling or function in the affected area.
• Injuries caused by a human or animal bite.
• Wounds caused by a rusty object.
• Wounds with objects or debris stuck inside.

A doctor should also be consulted about wounds that do not appear to be healing after 48 hours or injuries that are red, swollen, pus-filled or show other signs of infection.

The experts noted that getting the tetanus vaccine can help protect against the serious bacteria-borne illness that infects the body through cuts and puncture wounds. They pointed out that protection against tetanus doesn't last a lifetime and adults should get a tetanus booster shot every 10 years.

More information

The American Academy of Family Physicians provides more first-aid tips for cuts and scrapes.

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WEDNESDAY, May 1 (HealthDay News) -- The widely used antibiotic azithromycin (Zithromax or Zmax) -- under scrutiny recently because it may increase the risk of death for those with existing heart disease -- appears to be safe for young and middle-aged adults without heart problems, according to a large new study.

Danish researchers evaluated more than a million episodes of azithromycin use, comparing it to both the use of no antibiotics and to the use of penicillin V, from 1997 through 2010. Patients were aged 18 to 64.

"We believe that the results are reassuring," said Henrik Svanstrom, a researcher at Statens Serum Institute, in Copenhagen. His study is published in the May 2 issue of the New England Journal of Medicine.

"Our study shows no increased risk in the general population of young and middle-aged adults," he said. That, he added, "would reinforce the hypothesis that any increased risk of cardiovascular [death] associated with azithromycin is restricted to high-risk patients -- for instance [those] with a history of cardiovascular disease."

More than 56 million prescriptions were written for azithromycin in the United States in 2011, according to the IMS Institute for Healthcare Informatics. That compares to about 54 million written in 2011 for amoxicillin, another popular antibiotic.

Azithromycin is prescribed for bacterial sinusitis, pneumonia, skin infections and infections linked with lung disease, among other problems.

Concern about azithromycin surfaced in 2012, after a study in which researchers estimated an absolute risk of 47 cardiovascular deaths for every 1 million prescriptions for azithromycin. The study prompted a statement from the U.S. Food and Drug Association, cautioning that those taking the drug should be aware of the potential for heart problems.

In March 2013, the FDA renewed the warning, cautioning that the drug and others in its class, known as macrolides, can cause abnormal changes in the electrical activity of the heart. That, in turn, may lead to a potentially fatal irregular heart rhythm. The FDA warned that those especially at risk of developing the abnormality are those who have existing heart problems such as rhythm abnormalities.

That begged the question about the safety of the antibiotic for those without heart problems.

In the Danish study, supported by grants from the Danish Medical Research Council, Svanstrom and his team looked at data on filled prescriptions, causes of death and patient characteristics.

They looked at azithromycin use compared to no antibiotic use. Patients not using an antibiotic, Svanstrom said, likely did not have an infection at the time.

Using azithromycin for the typical five-day treatment increased the risk of cardiovascular death nearly three times compared to no antibiotic use. When researchers compared azithromycin use to penicillin V use, however, there was no increased risk with the azithromycin.

When they compared each antibiotic by use per 1.1 million people, 17 people on azithromcyin died and 16 on penicillin died.

"This indicates that the increased risk in comparison to non-use is entirely explained by an increased risk of cardiovascular death associated with acute infection, rather than the treatment with azithromycin," Svanstrom said.

Decisions about medication use need to be made after weighing pros and cons, Svanstrom said. "Our study is just one piece of the puzzle," he said. "However, if this drug is needed in the general population, our results do not argue against its use."

The results are good news for those without heart problems, said Dr. Gregg Fonarow, director of the Ahmanson-UCLA Cardiomyopathy Center, who reviewed the study.

"This study provides welcome and reassuring news regarding the cardiovascular safety of the antibiotic azithromycin in the general population," Fonarow said. The large numbers are a strength of the study, he added.

"These findings suggest that for the general population of adults azithromycin can be safely prescribed without concerns regarding an increased risk of cardiovascular events," he said.

The risk for those with existing heart disease is still unclear, he said. Fonarow said those patients should talk with their doctors about the risks and benefits of each treatment option.

More information

To learn more about the FDA warning on azithromycin, visit the U.S. Food and Drug Administration.

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WEDNESDAY, May 1 (HealthDay News) -- For people who have suffered from cellulitis of the leg, a long course of low-dose penicillin prevents the painful infection from returning, British researchers report.

Once the penicillin is stopped, however, its protective effect diminishes and the condition can flare up again, the researchers noted.

"Low-dose penicillin substantially reduces the risk of further episodes of leg cellulitis in those who have had two or more previous episodes," said lead researcher Hywel Williams, a professor of dermato-epidemiology at the University of Nottingham.

"The penicillin reduced recurrences from 37 percent in the group taking placebo to 22 percent in those taking penicillin," Williams said. "But this effect only occurred in the period that folks took the penicillin. When they stopped the 12 months of penicillin, the protective effect wore off."

Cellulitis is a common infection of the skin and deep underlying tissues. The two most common causes are Staphylococcus (staph) bacteria and group A strep. The bacteria enter the body through an injury such as a bruise, burn, surgical cut or wound, as well as through athlete's foot.

Symptoms can include fever and chills, swollen glands or lymph nodes, and a rash with painful, red, tender skin. In addition, the skin may blister and scab over.

The usual treatment is antibiotics, but the condition commonly returns when treatment is stopped.

Doctors and their patients now have reliable information on a possible way of reducing recurrences of this disabling and painful recurrent disease, Williams said.

"We now know for the first time that low-dose penicillin works, but we don't know how long it should be taken for and whether giving long-term antibiotics may cause resistance problems in the community in the long term, or whether it should be given for people with a first episode of cellulitis or just those with two or more previous episodes," he said.

The report was published in the May 2 issue of the New England Journal of Medicine.

One expert doesn't think this treatment is anything new.

"I know keeping you on antibiotics will prevent cellulitis from recurring," said Dr. Michele Green, a dermatologist at Lenox Hill Hospital, in New York City. "The problem is that the protective effect diminishes once drug therapy is stopped.

"This is what I do with older people. I keep them on antibiotics for a longer period of time so that they don't have a problem, but once you take them off they're just as vulnerable as they were before," Green said. "That's just common sense."

In addition, Green worries that keeping people on antibiotics for extended periods helps build the bacteria's resistance to the drug.

For the new study, Williams' team randomly assigned 274 people who had suffered from cellulitis of the leg that had been treated to one year of treatment with low-dose penicillin or placebos.

Over three years of follow-up, people taking penicillin saw a recurrence of cellulitis 626 days after the drug was stopped, compared with 532 days for those in the placebo group, the researchers found.

While on penicillin, 30 people had a recurrence of cellulitis, compared with 51 patients taking the placebo, they found.

More information

To find out more about cellulitis, visit the U.S. National Library of Medicine.

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TUESDAY, April 30 (HealthDay News) -- Preteen girls may get the same immune response against human papillomavirus (HPV) with two doses of vaccine as young women get with the full three-shot series, a new study suggests.

HPV is a sexually transmitted infection that causes cervical cancer, the second biggest cancer killer in women around the world.

The HPV vaccine, approved by the U.S. Food and Drug Administration in 2006, is given in a three-shot series. The first and second doses are given one to two months apart, followed by a third dose six months later.

Current government guidelines advise parents to vaccinate boys and girls against HPV starting at age 11. That's partly to ensure they're protected against HPV before their first sexual encounter, but it's also to take advantage of biology.

"The immune response wanes with age. So the younger you are, the better immune response you have," said Dr. Jessica Kahn, a pediatrician at Cincinnati Children's Hospital Medical Center in Ohio. Kahn wrote an editorial on the study, but she was not involved in the research.

Although HPV vaccines are considered highly effective, fewer than one-third of U.S. teens receive all three doses, according to the U.S. Centers for Disease Control and Prevention's National Immunization Survey of Teens.

Doctors have wondered if a different dosing schedule might save money and time while still providing the protection of the three-dose regimen.

To find out, researchers in Canada, where vaccines are delivered through school-based programs, randomly assigned 520 girls aged 9 to 13 to receive either two or three doses of the Gardasil vaccine, which protects against four HPV strains. The girls who got two doses got their shots six months apart. The girls who got three doses got the vaccines on the regular schedule.

The younger girls were compared to 310 young women aged 16 to 26 who got three doses of the vaccine on the regular schedule.

Researchers took blood samples to measure the number of antibodies made against each viral strain. They continued to take blood samples over time to see how long the antibody response might last.

The younger girls who got two doses of vaccine appeared to make at least as many antibodies against the HPV strains as the teens and young women did on the three-dose regimen. And their protection appeared to last just as long, up to three years after they started their shots, according to the study, published April 30 in the Journal of the American Medical Association.

The researchers cautioned that while the antibody response to two doses of the vaccine looks promising, it doesn't prove that the shorter course actually protected against viral infections or cancers. A much longer study is under way to test that.

But study author Dr. Simon Dobson, a clinical associate professor with the vaccine evaluation center at the University of British Columbia, said the results are encouraging because they suggest that younger girls could get two doses to prime their immune systems against HPV, and then get a later dose to boost that response closer to the time they might become sexually active.

"It raises the possibility that you could give two doses early in preadolescence, and then wait and give the third dose later in adolescence when the girls are going to be closer to the time when they're most likely to need protection against HPV," Dobson said.

Two doses would also save money, a key consideration especially in countries where resources are scarce. According to the CDC, the Gardasil vaccine cost about $130 a dose in 2012.

Until more is known, however, experts say girls should get all three doses.

Kahn said doctors don't know if two doses will be enough to fully protect teenage girls.

"We need data on girls older than 13. Because even though the vaccine is recommended to be targeted to 11- to 12-year-olds, girls in the 13- to 17-year-old age range are actually most likely to be vaccinated. We would need to see data on immunogenicity or immune response in the 13- to 17-year-old age range," said Kahn.

And although protection from the vaccine appears to last a long time, doctors still aren't sure how long, or whether three doses might protect for longer than two.

"The data are encouraging, but it's really too soon to change recommendations based on the results of this one study," Kahn says.

More information

For more on HPV vaccination, head to the U.S. Centers for Disease Control and Prevention.

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TUESDAY, April 30 (HealthDay News) -- A new study failed to find any evidence to back up a suggested association between Lyme disease and autism spectrum disorders.

Although a prevalence of Lyme disease as high as 20 percent (or even higher) has been reported in children with autism, the new research found no cases of Lyme disease in children when testing recommended by the U.S. Centers for Disease Control and Prevention was done.

Health experts are concerned that if parents suspect that Lyme disease has played a role in their child's autism, they may seek treatment with long-term antibiotic therapy.

"Unless a child has been diagnosed with Lyme disease or another infectious disease, our findings don't support the idea of putting autistic children on antibiotics," said study senior author Armin Alaedini, an assistant professor of medical sciences in the department of medicine and the Institute of Human Nutrition at Columbia University Medical Center, in New York City.

Results of the study appear in the May 1 issue of the Journal of the American Medical Association.

Autism is a developmental brain disorder that hinders a child's ability to communicate and interact socially.

Lyme disease occurs when a tick transmits the bacteria Borrelia burgdorferi to a human through its bite.

Symptoms of Lyme disease often include a rash with a bulls-eye appearance that's warm to the touch, fatigue, chills, fever, headache, muscle and joint aches, and swollen lymph nodes, according to the CDC.

Diagnosis is through a blood test. The most accurate results come from the use of two different tests, but this method isn't always used.

Alaedini and his colleagues wanted to investigate the suspected link using the CDC's preferred two-tiered approach. They analyzed blood samples from 70 children with autism and 50 children without autism or any other known conditions. The average age of the children with autism was slightly older than 7 years, and the average age of the unaffected children was 9 years old.

After testing with the first method, called ELISA, one child with autism tested positive and four tested as borderline. In the non-autistic children, four tested positive and one was borderline.

When the second test, called the Western blot, was done, none of the children tested positive for Lyme disease.

"We did the testing by the CDC-recommended two-tier testing and didn't find any of the children to be positive. Our sample size is large enough that these findings can rule out a high prevalence of Lyme disease in children with autism spectrum disorders," Alaedini said.

An expert who was not involved with the new study discussed the findings.

"This study points out the problems with Lyme serology. Sometimes a single blood test doesn't do it. And, in any study of Lyme disease, you have to look critically at how they tested," explained Dr. Kenneth Bromberg, chairman of pediatrics and director of the Vaccine Research Center at the Brooklyn Hospital Center, in New York City.

"When these researchers did the CDC recommended testing, they couldn't find the prevalence of Lyme that others found," he noted.

Lyme disease primarily occurs in the northeastern part of the country, though it can happen anywhere. In 2011, the CDC estimates that 96 percent of Lyme disease occurred in 13 states: Connecticut, Delaware, Maine, Maryland, Massachusetts, Minnesota, New Hampshire, New Jersey, New York, Pennsylvania, Vermont, Virginia and Wisconsin. In these areas, Lyme disease is considered endemic, which means it's regularly found there.

Bromberg said it's important to take precautions when outdoors to protect against Lyme, but not for fear of autism. "Avoiding Lyme has nothing to do with autism, it's to avoid Lyme. Wear protective clothing and do tick checks when you come indoors," Bromberg said.

More information

To learn more about Lyme disease, including ways to prevent it, visit the U.S. Centers for Disease Control and Prevention.

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