The Vitals - February 2015

February 2015, Vol 3, No 2 - The Vitals

In This Issue

Alaska State Happiest in the United States

According to the Gallup-Healthways Well-Being Index, residents from the state of Alaska have the highest well-being ranking in the nation.

The other states ranking in the top 3 include Hawaii and South Dakota, with West Virginia ranking last for the sixth consecutive year, and Hawaii and Colorado being the only 2 states ranking in the top 10 every year since 2008.

These data were compiled from more than 176,000 interviews conducted with US adults across all 50 states between January and December 2014. The Well-Being Index is calculated on a scale of 0 to 100, with 0 being the lowest possible well-being. In addition, the metrics affecting well-being include 5 specific elements: (1) purpose, with the person liking what they do each day and being motivated to achieve their goals; (2) social, having supportive relationship and love in their life; (3) financial, managing their economic life to reduce stress and increase security; (4) community, liking where they live, feeling safe, and having pride in their community; and (5) physical, having good health and enough energy to get things done daily.


  1. Gallup-Healthways Well-Being Index. Alaska Leads US States in Well-Being for First Time. www.well-beingin Published February 18, 2015. Accessed February 24, 2015.

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Long-term Benzodiazepine Use Still Common

According to a recent study published in the February issue of JAMA Psychiatry, long-term use of benzodiazepine remains common in older patients.

“Although concern exists regarding the rate of benzodiazepine use, especially long-term use by older adults, little information is available concerning patterns of benzodiazepine use in the United States,” reported Mark Olfson, MD, MPH, Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, and colleagues.

The investigators sought to describe benzodiazepine prescription patterns in the United States, focusing on patient age and duration of use. Using the 2008 LifeLink LRx Longitudinal Prescription analysis, which includes 60% of retail pharmacies in the United States, Dr Olfson and colleagues performed a retrospective descriptive analysis of benzodiazepine prescriptions. Outcomes of interest included the percentage of adults filling ≥1 benzodiazepine prescriptions by sex and age-group. Among patients receiving the drug, the investigators evaluated the corresponding percentages with long-term (≥120 days) benzodiazepine use, as well as prescription of a long-acting benzodiazepine, and benzodiazepine prescriptions from a psychiatrist.

Approximately 5.2% of US adults between 18 and 80 years of age used benzodiazepines in 2008, with the percentage of patients who used it increasing with age (2.6% in patients 18-35 years; 5.4%, 36-50 years; 7.4%, 51-64 years; and 8.7%, 65-80 years). In addition, the investigators found that the use of the drug was almost twice as prevalent in women compared with men, and that the proportion of long-term benzodiazepine use increased with age, whereas the proportion of patients who were prescribed the drug from a psychiatrist decreased with age.

Dr Olfson and colleagues concluded that more vigorous clinical interventions supporting judicious use of benzodiazepines are needed to potentially decrease rates of long-term benzodiazepine use in older patients.


  1. Olfson M, King M, Schoenbaum M. Published February 2015. Accessed February 24, 2015.

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The Bourbon Virus Identified

The Centers for Disease Control and Prevention (CDC) has identified a new virus, the Bourbon virus, which may be associated with the death of a 50-year-old man.

The patient was from the county of Bourbon, Kansas, and experienced multiple tick bites while working outside. He fell ill over the next 2 days, went to a physician on day 3, was hospitalized, and died of a myocardial infarction 11 days after he became sick.

The virus belongs to a group of viruses called Thogotoviruses, and although viruses in this group can be found all around the world, few of them can make people sick. Although the CDC does not fully know how the virus may be transmitted, based on similar viruses, it is possible that the Bourbon virus may be transmitted by tick or insect bites.

Since there is only 1 case in the United States that may be associated with this virus, the symptoms for the Bourbon virus are still being researched. Clinical signs and symptoms reported by the patient who recently died in Kansas included fever, fatigue, anorexia, nausea, vomiting, and a maculopapular rash. The patient also had thrombocytopenia and leukopenia. Treatment with doxycycline was not effective.

To reduce the chance of becoming infected with the Bourbon virus, the CDC recommends using the regular precautions when outdoors to avoid tick and bug bites, such as using insect repellent, wearing long sleeves and pants, avoiding bushy and wooded areas, and performing thorough tick checks after spending time outdoors.


  1. Ellis R. Man’s death leads to discovery of new virus in Kansas, CDC reports. Published February 20, 2015. Accessed February 24, 2015
  2. Centers for Disease Control. Bourbon virus. Updated February 19, 2015. Accessed February 24, 2015.

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Health Policy

5 Facts About HR 471

  1. HR 471 is called the Ensuring Patient Access and Effective Drug Enforcement Act of 2015
  2. Introduced to the House by Representative Tom Marino on January 22, 2015
  3. The bill amends the Controlled Substances Act to define factors that may be relevant to and consistent with public health and safety, and an imminent danger to public health or safety
  4. It requires an order to show why registration should not be denied, revoked, or suspended
  5. The bill also directs the Secretary of Health & Human Services to submit a report identifying obstacles to legitimate patient access to controlled substances, issues with diversion of controlled substances, and how the collaboration between federal, state, local, and tribal law enforcement agencies and the pharmaceutical industry can benefit patients and prevent diversion and abuse of controlled substances


  1. Congressional Research Service. Summaries for the Ensuring Patient Access and Effective Drug Enforcement Act of 2015. Accessed February 24, 2015
  2. Congress.Gov. H.R.471 - Ensuring Patient Access and Effective Drug Enforcement Act of 2015. Updated February 22, 2015. Accessed February 24, 2015.

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Smallpox Vaccine Use, Postevent Vaccination Program

The Centers for Disease Control Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, recently released a report pertaining to the clinical guidance for the use of smallpox vaccines in a postevent vaccination program.

The report outlines recommendations for clinical use of the 3 smallpox vaccines stored in the US Strategic National Stockpile for people who are exposed to smallpox, or who are at high risk for smallpox infection during a postevent vaccination program following an intentional or accidental release of the virus.

Smallpox vaccines are made from live vaccinia viruses that protect against smallpox disease, but they do not contain the variola virus, which is the causative agent of smallpox. The 3 smallpox vaccines stockpiled are ACAM2000, Aventis Pasteur Smallpox Vaccine, and Imvamune.

Persons who are exposed to the smallpox virus are at high risk for developing and transmitting smallpox, and should be vaccinated with a replication-competent smallpox vaccine—unless they are severely immunodeficient. People without a known smallpox virus exposure may still be at high risk for smallpox infection depending on the magnitude of the outbreak, and the effectiveness of the public health response. In this case, the person will be defined by public health authorities and should be screened for contraindications relative to smallpox vaccination (eg, atopic dermatitis, human immunodeficiency virus infection, other immunocompromised states, vaccine or vaccine-component allergies). Patients with relative contraindications should be vaccinated with Imvamune when it is available and authorized for use by the US Food and Drug Administration.

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Last modified: April 1, 2016
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