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Italian doctor Paolo Zamboni made world news with his experimental treatment for MS, which immediately prompted calls for studies. (Alessandro Vincenzi/Alessandro Vincenzi/The Globe and Mail)
Italian doctor Paolo Zamboni made world news with his experimental treatment for MS, which immediately prompted calls for studies. (Alessandro Vincenzi/Alessandro Vincenzi/The Globe and Mail)

Paul Taylor's Small Doses

The Obama effect and the year in medicine Add to ...

Using the same approach, that would mean between 780 and 2,900 H1N1 deaths in Canada. That's significantly fewer than the roughly 4,000 or more Canadians who die in a "normal" flu season. (The estimate from the Public Health Agency of Canada stood at 336 in mid-December - but this figure represents only confirmed deaths directly linked to H1N1.)

"Our work shows that the severity of H1N1 may be less than initially feared," said Marc Lipsitch, who led the research team at Harvard.

Does that mean public health officials over-reacted to the perceived threat? No, says Dr. Lipsitch. "It's a sign of good judgment in public health to prepare for something worse than actually happens, because you can't know until it happens how bad it's going to be."

He also noted that H1N1 hit some younger people especially hard, while the seasonal flu tends to take its biggest toll among the elderly.

"It's still bad. It's still putting people in hospital and it's killing more children than normal seasonal flu," said Dr. Lipsitch. "So it's not harmless, but it's milder than other pandemics have been."

While public health officials may have acted prudently, there were some snags and lessons to be learned for the next pandemic. H1N1 infections started to peak in Canada well before ample supplies of the vaccine could be produced and distributed across the country. Some experts say Canada may be better served by using multiple vaccine suppliers, rather than relying on just one company.

Folic acid folly?

For more than a decade, food manufacturers in Canada and the United States have been required by law to add folic acid to bread, pasta, flour and other grain products. The fortification effort is meant to ensure that women receive adequate levels of folic acid in case they become pregnant. The B vitamin is critical in the early stages of fetal development.

And, by all accounts, the mandatory program has been highly successful in reducing certain birth defects such as spina bifida, which has plunged by 50 per cent to about 110 cases a year in Canada.

However, other research has hinted that there might be a dark side to fortification - fuelling cancers in the general population.

Two studies, published earlier this year, suggested folic acid supplements may boost the odds of getting prostate and colon cancers.

Then, in November, yet another study showed an overall increase in cancer cases and deaths among Norwegians taking folic acid pills.

Although these findings are worrisome, experts generally agree there's not enough evidence to justify pulling the plug on folic acid fortification.

Still, it's certainly a research field worth watching. Policy makers may eventually be compelled to revisit a program that essentially treats everyone the same way - rather than targeting just those who are supposed to benefit from it.

New hope for MS?

An Italian doctor has captured international attention with a new theory - and possible treatment - for multiple sclerosis.

Paolo Zamboni, a professor of medicine at the University of Ferrara, has published a series of papers suggesting that a narrowing of blood vessels in the neck could contribute to the development of MS. According to Dr. Zamboni, veins draining blood from the brain are malformed, or become blocked, leading to a buildup of iron in the brain which, he thinks, causes the neurological symptoms of MS.

By increasing blood flow, through a relatively simple operation, he believes symptoms can be reversed or minimized. The procedure has been performed on 65 MS patients, including Dr. Zamboni's wife, with mixed results.

The medical community looks upon Dr. Zamboni's work with some degree of skepticism. "We have seen similar claims of potential causes and cures in the past," the University of British Columbia MS Clinic said in a recent statement.

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