Hepatitis

With days to go before the start of school, thousands of students in Baltimore lack required immunizations, a number that, though far lower than at the corresponding time last year, has city school officials scrambling. Nearly 3,500 students in prekindergarten through 10th grade lack required immunizations, said Tom DeWire, the city school system's SchoolStat director. DeWire is optimistic that the stragglers - including more than 2,100 high school students who need to complete the hepatitis B and chickenpox vaccinations that the state requires for all students through 10th grade - will be reached.

As the first day of school approaches, parents are checking to make sure their children are up to date on their vaccines. By the time Maryland children enter kindergarten, they are required to have been vaccinated against 11 diseases -- diphtheria, pertussis, Hib (haemophilus influenza), pneumococcus, tetanus, polio, measles, mumps, rubella, hepatitis and chicken pox. And, this year, both the Centers for Disease Control and Prevention and the American Academy of Pediatrics are recommending that children receive four new vaccines: a booster for chicken pox, rotavirus, hepatitis A and the human papillomavirus, says Julie Yeh, assistant chair of pediatrics at the Greater Baltimore Medical Center.

Human Genome Sciences Inc. reported clinical trial data yesterday showing that Albuferon, a hepatitis C drug the Rockville biotech is developing, is comparable to a current therapy and may do less damage to patients' quality of life during treatment. It also had a benefit of particular interest in the United States, where a large percentage of patients are overweight: The drug appeared to work better in heavier people than its alternative, a drug called Pegasys made by Hoffmann-La Roche Inc. But Albuferon, one of two drugs the company is relying on for eventual revenue, also had higher rates of patient discontinuation because of adverse events - particularly at the higher dosing levels.

Doctors and researchers almost never use the word "cure," but they came as close as they ever do this week describing a combination of drugs used to treat the severe liver disease hepatitis C. Among some patients, the drug cocktail of pegylated interferon and ribavirin completely kills the virus that causes hepatitis C, and keeps it from coming back, doctors reported at a Digestive Disease Weekly conference in Washington. The catch is, the drug combo does not work in about half of people with hepatitis C, and researchers still are not sure why it works so completely for some but fails in others.

Even after school officials told Danielle Fishback, 14, that she would have to get vaccinations for chickenpox and hepatitis B or she wouldn't be allowed to return to Wilde Lake High School after winter break, she hesitated at the thought of the needles. "I didn't want to take it. I was scared," she said. "During winter break, I didn't think about it." Fishback, a ninth-grader who lives in Columbia, was one of thousands of Maryland students who missed school this week for failing to comply with new regulations requiring schools to exclude students who hadn't received the vaccines.

Some Maryland students were sent home from school this week while thousands more face a dwindling grace period to get up to date on chickenpox and hepatitis B vaccinations. New regulations, which affect mostly sixth- through ninth-graders, included a Jan. 1 deadline that required schools to exclude those who have not received the vaccines or, in the case of chickenpox, have not documented when they had the illness. Many students are taking advantage of a 20-day window in which they can attend classes if they show they have an appointment to get their shots.

Children entering grades five through nine this fall may need to get extra shots this summer to comply with new statewide immunization requirements. If students don't have documentation that they have received vaccinations for chicken pox and hepatitis B by the first day of school, they will be turned away, said Rhonda Gill, the school system's director of student services. "They won't be able to attend school. That's what makes it a very serious matter," Gill said. School system officials are sending letters to parents, and information about the shots needed is available on the county schools' Web site and from the Anne Arundel County Department of Health.

Human Genome Sciences Inc. yesterday announced a $507 million collaboration with Switzerland's Novartis to develop and commercialize the Rockville biotech's hepatitis C drug, Albuferon. The announcement jolted trading of Human Genome's stock, with shares moving at more than five times the normal volume. Shares rose 41 cents, or 4 percent, to close at $10.60 on the Nasdaq yesterday. Such partnerships are becoming more common in the drug development world. Smaller biotech concerns are often idea-rich, but cash-poor, while big pharmaceutical companies are often in the opposite camp, looking to partner with others to further their drug portfolio.

Some Maryland children might need to roll up their sleeves for a few more vaccinations before school begins next fall. By Sept. 1, pupils entering prekindergarten to ninth grade will have to show records to prove their immunity to hepatitis B and varicella, more commonly known as chickenpox. Preschoolers will also need a pneumococcal vaccine that protects against bacterial meningitis, blood infections and common ear infections. In Maryland, vaccinations are covered by most insurance plans, or children could go to immunization clinics held by local health departments; Baltimore County has scheduled clinics for this month.

A five-month state investigation of a mysterious hepatitis C outbreak has failed to determine conclusively how a Timonium pharmacy infected 16 people with the disease. However, a summary of the findings released yesterday by the Maryland Department of Health and Mental Hygiene did cast suspicion on a tainted blood sample. The probe focused on a single contaminated vial of radioactive tracer prepared by the Timonium pharmacy Oct. 15. The tracer was sent out to three area clinics for use in routine cardiac stress tests.