Digg delicious reddit MySpace StumbleUpon LinkedIn Mumps outbreak reaches nearly 2,000 in New York and New Jerse

Health officials in New York and New Jersey are urging those in the affected communities to get vaccinated.

Atlanta, Georgia (CNN) -- Nearly 2,000 people, mostly adolescent and young adult males in Orthodox Jewish communities in New York and New Jersey, have contracted mumps since last summer, according to health officials.

In Thursday's Morbidity and Mortality Weekly Report, the Centers for Disease Control and Prevention (CDC) reports 1,521 mumps cases, using data collected before end of January. But CNN has learned that the number is now at least 1,996.

New York City Health officials report 909 confirmed cases as of February 8. Most of those sickened are young adult males, said Dr. Jane Zucker, assistant commissioner for the New York Department of Health and Mental Hygiene.

New York state health officials told CNN that Orange County, New York, is reporting 611 confirmed cases and neighboring Rockland County reports 317. Ocean County, New Jersey, health officials have at least 159 confirmed cases. Health officials in all jurisdictions are still investigating other possible cases of mumps.

CDC officials trace the origin of this outbreak to a summer camp for Orthodox Jewish boys in Sullivan County, New York, last June. That's when an 11-year-old boy arrived at the camp after having spent time in the United Kingdom, which has been dealing with its own mumps outbreak -- it saw about 7,400 cases last year.

Health officials say that boy -- referred to as the "index case" -- infected others attending the summer camp. After leaving the camp, they then transmitted the illness to their communities when they returned home.

Both the CDC and health officials in New York and New Jersey say the outbreak is still primarily confined to specific religious communities in their states. "Much of the current outbreak is occurring in congregate settings, where prolonged, close contact among persons might be facilitating transmission," CDC officials say in the weekly report.

Health officials say they believe there are several reasons why this outbreak is confined to these religious communities. One is that young men in particular are spending many hours in school, "often face-to-face with a study partner," according to the CDC's weekly report. It is likely community transmission also occurs within large families.

Mumps is spread by people sneezing or coughing, sending the virus-laden droplets through the air. People can also get infected by touching surfaces that a sick person has touched. Once infected, someone can transmit the virus for a day or two before showing any symptoms of the illness and for up to five days after symptoms appear, according to the CDC.

Symptoms of illness include fever, headache, muscle aches, loss of appetite and swelling of the salivary glands, causing the jaw and cheeks to swell. More serious complications can include inflammation of the brain, swelling of the testicles or ovaries, and deafness, according to the CDC. Adults are at higher risk for serious complications.

Health officials note that lack of vaccination is not to blame in this mumps outbreak, which is the largest since 2006, when 6,584 were in an outbreak that originated on a college campus.

"This is a well-vaccinated community," said Zucker from New York City's health department.

But the vaccine isn't 100 percent effective. Vanderbilt University's Dr. William Schaffner, who also is president-elect of the National Foundation for Infectious Diseases, says studies have shown that the mumps vaccine is about 85 percent effective.

Children are supposed to receive their first mumps vaccine when they are 12 to 15 months old, and then get a second shot when they are 4 to 6 years old, according to the CDC.

The CDC notes in the weekly report that this outbreak shows that mumps can occur in highly vaccinated populations. However, Schaffner added that the mumps vaccine "is not perfect but considerably effective, and if someone gets the mumps even though they've been immunized, the symptoms will be milder."

That is why health officials in both states are urging those in the affected communities to get vaccinated.

Malaria, genetic diseases plagued King Tut

(CNN) -- The legendary Egyptian "boy king" Tutankhamun, commonly known as King Tut, died of conditions including malaria and complications from a leg fracture, according to a study published this week in the Journal of the American Medical Association.

Tutankhamun's tomb was discovered in 1922, but his life remains shrouded in mystery, and not much is known about him. He ruled during the 18th Dynasty, from 1336 B.C. to 1327 B.C., according to the Web site Egyptology Online, and is believed to have died young. Forensic analysis of his mummy has put his age of death at about 17 to 19 years.

In the study published this week, researchers used anthropological, radiological and genetic testing to examine Tut and 10 other bodies mummified over a two-year period during Tut's dynasty.

Previously, based on historical records and earlier digs, Zahi Hawass, the lead investigator of the study, had said Tut could have been the son of Amenhotep III, a successful and popular king of the 18th Dynasty, who was later known as Akhenaten.

Through DNA, Hawass' researchers determined that was indeed the case, and that Tut was married to his sister. Scientists believe that genetics and inherited diseases played a role in Tut's health because of inbreeding within the family.

"We know there were weaknesses in these mummies, perhaps even cardiovascular problems," Hawass said.

Video: What killed King Tut?

When researchers scanned Tut's mummy, they found he not only had severe kyphoscoliosis, or curvature of the spine, but also suffered from a toe malformation known as oligodactyly. The condition made his left foot swell, and it would have caused excruciating pain when he walked.

"In ancient drawings we see Tut shooting arrows, not standing, but sitting in a chariot. This was unusual," Hawass said. "In his tomb, we also found 100 walking sticks. Originally we thought they represented power. But they were ancient crutches that he obviously used. He could barely stand."

Hawass said by taking his prior research and combining it with his most recent findings, the cause of Tut's death became pretty clear to him.

"The purpose of the CT scan (in 2005) was to see if he was murdered, because earlier X-rays had found there was a hole in his skull," Hawass said. "But we found the hole was made during mummification. However, we did find a large fracture in his left femur that probably contributed to his death."

Hawass theorized a fall could have hastened Tut's death. But DNA testing also showed evidence of plasmodium falciparum, a protozoan parasite that causes malaria in humans. The parasite has been found in many other mummies, as well. Hawass said he believes the combination of the serious fracture and the deadly parasite killed the young king.

"This is very exciting that we can take modern technology and learn more about Egyptian history," said Howard Markel, a medical historian at the University of Michigan's Center for the History of Medicine.

"Mummies are very powerful tools," he said. "We can learn a lot from the dead, how illnesses evolve."

Would you know if your heart was in trouble?

(CNN) -- When Eugenie Smith's hands started tingling, she figured her biking gloves needed more padding. When she felt out of breath after a short walk on a treadmill, she assumed it was pneumonia. When her chest hurt, Smith chalked it up to indigestion.

She was wrong, wrong, wrong.

Smith was actually having a heart attack, and needed three stents. She was 46 at the time, and in otherwise perfect health.

While it may sound odd to miss the signs of something as monumental as a heart attack, cardiologists say they see it quite often.

It happens "ALL THE TIME!!!" Dr. Kenneth Rosenfield, an interventional cardiologist, wrote in an e-mail. "Every week. Seriously."

Rosenfield says a "Hollywood heart attack" -- the kind where you collapse to the ground clutching your chest -- is the exception, not the rule. "We need to do a better job of letting people know what are all of the types of symptoms that can indicate a heart attack," he says.

Smith couldn't agree more. Looking back at her heart attack eight years ago, she now sees she had symptoms for six months and missed them. "My message to everyone is simple: If your symptoms are frequent do not hesitate. Have them checked before it is too late," she says.

Former President Bill Clinton was hospitalized last week and received two stents after he experienced brief periods of discomfort over several days. Clinton, who'd undergone bypass surgery in 2004, said he began feeling tired around Christmas. "I didn't really notice it until about four days ago when I felt a little bit of pain in my chest, and I thought I had to check it out," he said.

The signs that you're having a heart attack -- or that your arteries are so clogged up you're about to have one -- vary from person to person. You can listen to heart attack patients describe what it felt like to them, and the American Heart Association, the National Heart Lung and Blood Institute, and the Mayo Clinic have lists of heart attack symptoms and warning signs.

Here's a list of some of the more common signs:

1. Chest discomfort

While not everyone feels it, chest pain or discomfort is still the most common sign of a heart attack, according to the American Heart Association.

The pain isn't necessarily overwhelming. "It was a relatively mild pain that I kept expecting to go away, but it never did," says Duane Marcus, 56, of Stone Mountain, Georgia, who had a heart attack two weeks ago.

Read more Empowered Patient

Rolanda Perkins, who had a heart attack just over four years ago at age 39, says at first she ignored her chest pain because she thought it was indigestion. "I figured I could go to the doctor in the morning, but morning came for me at about 3:30 [a.m.] when the pain got worse and I had a shortness of breath," she remembers. "I knew that something was wrong."

In recent years Perkins, who lives in Tennessee, has completed two half-marathons. Now she tells people to listen to their bodies. "My body was speaking to me, and I was not listening," she says.

2. Discomfort in other parts of the upper body

Rob, an Atlanta businessman who asked that his last name not be used, said pressure behind his ears while working out on the stair-stepper was the first sign that something wasn't right.

He was 50 and on vacation at the time, and he didn't think much of it. But when he got back home he also started to experience a bit of tightness in his chest while exercising.

It seemed so strange that he walked into a cardiologist's office without an appointment and insisted on seeing the doctor. He had bypass surgery the next day.

Rosenfield, head of vascular medicine and intervention at the Massachusetts General Hospital, says pain in a variety of places can indicate a heart attack.

More on heart issues at Matters of the Heart

"I often tell my patients that they should be mindful of any symptom from the waist up which seems different or unusual," he says, including "heaviness, pressure, squeezing, aching, or discomfort in the chest, back, neck, shoulders, or arms, wrists, elbows, between the shoulder blades, aching in the jaw, throat, or even gums or earlobes."

Of course, discomfort in any of those areas could mean myriad other problems and not a heart attack at all.

So how do you know the difference?

Rosenfield says pay particularly close attention if you have a personal or family history of heart disease or risk factors such as high blood pressure or high cholesterol. Other reasons to be on guard is if the symptoms are particularly intense, happen for no apparent reason, if they get worse with exercise, if they don't go away, or if they go away and come back.

3. Gastrointestinal problems

When Dr. Malissa Wood's father complained about stomach pain and nausea, she paid close attention because he said it felt different from ulcer problems he'd had in the past, and because he had a history of high blood pressure and vascular disease.

Wood, a cardiologist and assistant professor of medicine at Harvard Medical School, made sure her father received quick attention, and it turned out his right coronary artery was 92 percent blocked, requiring stents and bypass surgery.

4. Flulike symptoms

Dr. Robert Superko says he's seen it many times: A patient's routine EKG will show signs of an old heart attack, but when he asks whether the patient has had a heart attack the person says no, adding, "But, oh yeah, doc, last year I had a really bad flu."

Superko, a cardiologist and author of the book "Before the Heart Attacks," says significant fatigue, feeling exhausted for several days, gastrointestinal problems (see above) and a general feeling of not being well can be signs of a heart attack or heart problems -- and they're easy to miss. "You can see how people could just write it off as the flu," he says.

5. Shortness of breath

Shortness of breath can be a sign of a heart attack even if you don't have any chest pain or discomfort.

For Olympians and weekend warriors, winter sports can trigger asthma

Norwegian cross-country skier Marit Bjørgen won the bronze medal, even though she uses asthma medication.

(Health.com) -- Do you cough, wheeze, or get short of breath when you exercise in cold weather? You could have asthma, but you've got plenty of company. Exercise-induced asthma is surprisingly common among people who work out in cold climates, whether they're jogging around the neighborhood or gunning for gold in Vancouver.

This week, for example, Norwegian cross-country skier Marit Bjørgen won the bronze medal in the women's 10-kilometer race, even though she uses asthma medication. In fact, half of cross-country skiers and one-quarter of aspiring winter Olympians in general have exercise-induced asthma, according to a 2000 study of 170 athletes conducted by the United States Olympic Committee.

"Any [exercise] outdoors on a mountaintop is a culprit, but just jogging in Central Park will do it as well," says Dr. Len Horovitz, a pulmonary specialist with Lenox Hill Hospital, in New York City. Exercise-induced asthma doesn't have to slow you down, however. With the right medications and precautions, exercise-induced asthma won't keep you from your daily workout, or even from competing at an elite level.

How cold and exercise cause asthma

Wheezing, chest tightness, and the other symptoms of exercise-induced asthma generally begin several minutes after you begin working out. For some people, the symptoms start soon after they finish exercising.

Although athletes who compete in warm-weather sports may suffer from exercise-induced asthma as well, mixing exercise and cold, dry air is especially problematic. For many people with regular asthma, in fact, just stepping outside in frigid temperatures is enough to cause symptoms.

Health.com: Star athletes with asthma

"Both cold air and exercise in and of themselves can trigger asthma symptoms, but doing them together is more likely to trigger an exacerbation," says Dr. Thomas M. Leath, an assistant professor of pediatrics at Texas A&M Health Science Center College of Medicine.

When the air is dry -- as it often is in cold climates during the winter -- your lungs can become even more irritated, Horovitz adds. "The evaporative loss and cooling of the airways triggers the process of bronchial constriction," he says. "One sport you don't see exercise-induced asthma in so much is swimming. The humidity at water level is such that there isn't as much evaporation as in running or winter sports." (Chlorine, however, can trigger asthma symptoms, Horovitz notes.)

Health.com: Chlorine triggers my asthma, but I'm still a triathlete

The combination of cold air and exercise is "a double whammy," says Dr. Steve N. Georas, the director of pulmonary and critical care medicine and the director of the Mary Parkes Center for Asthma, Allergy and Pulmonary Care at the University of Rochester Medical Center, in New York.

The bronchospasms that characterize exercise-induced asthma refer to a contraction (or spasm) of lung airways. Experts aren't certain what's behind this phenomenon. One theory is that the increased blood flow caused by exertion forces the blood vessels in the airways to expand, leading to constriction of the airways, Georas says. Another theory holds that cold air activates certain inflammatory cells in the airways.

"Asthma [is] as an inflammatory disease where, for some reason, the body's immune response has sent out an alarm about something going wrong in the lungs," says Georas. "Once that alarm has been set off, there's airway inflammation."

Health.com: Try this game: Asthma word search

How to fight it

The first-line treatment for exercise-induced asthma is a bronchodilator. Usually delivered via rescue inhalers, these drugs (such as albuterol) fight symptoms by relaxing the muscles that line the airways in the lungs.

The most commonly used bronchodilators, a class of drug known as beta2-agonists, are prohibited by the International Olympic Committee (IOC). Because beta2-agonists can promote muscle growth, athletes with asthma must prove they have the disorder and must receive permission to medicate themselves; otherwise, they run the risk of being disqualified from the Games. "The IOC has really cracked down on this," says Georas. "A few years ago, a lot of people declared themselves asthmatic, which was thought to be a way to get inhaled steroids."

Health.com: 7 Surprising triggers of lung trouble

Fortunately, if you don't need the IOC to sign off on your medications, preventing and treating exercise-induced asthma is pretty straightforward. The best treatment will depend on how often you experience exercise-induced asthma, and whether you can predict when it will occur.

If you experience asthma symptoms every time you exercise in cold weather, you may want to use a bronchodilator 10 to 15 minutes before exercising to prevent an attack, Horovitz recommends.

If your asthma isn't predictable, keep an inhaler handy while you exercise instead of using it beforehand. "There are patients in whom it's intermittent. Sometimes they can exercise, sometimes they can't," says Georas. "If you feel chest tightness coming on, have your inhaler on you."

Health.com: 10 Best big cities for people with asthma

In addition to medication, there are other precautions athletes can take. Warming up for a few minutes before hitting full exercise mode, breathing through your nose (to warm and humidify the air before it hits your airways), and wearing a scarf or face mask around your mouth can all prevent symptoms, says Leath. Masks that contain inserts known as heat exchangers have also been shown to fight exercise-induced asthma in cold weather.

These treatments are effective enough that exercise-induced asthma rarely keeps people from the winter sports they enjoy. Leath has heard many patients complain of cold air making their asthma worse, but he hasn't seen any asthma exacerbations so severe that they prevent winter activity.

"The whole goal of asthma therapy with each patient is to allow them to conduct their daily activities unfettered," says Georas.

Navy opens review of care Murtha received in surgery

Washington (CNN) -- The National Naval Medical Center has opened a review of the surgical care provided to the late Congressman John Murtha after the Pennsylvania Democrat died following surgery, a senior U.S. military official told CNN Wednesday.

The official declined to speak on the record citing privacy concerns, but confirmed to CNN that the review includes an in-depth "quality assurance review of the outcomes" of the care Murtha received.

The Navy is keeping the Murtha family apprised of its findings.

Murtha had his gallbladder removed by laparoscopic surgery January 28 at the National Naval

Medical Center in Bethesda, Maryland. He later became ill and was admitted to Virginia Hospital Center's intensive care unit January 31 in Arlington, Virginia. Murtha died there February 8 at the age of 77.

Military sources say it's believed Murtha's intestine may have been nicked during the initial procedure, leading to massive infection. A source close to the congressman confirmed that theory to CNN's senior medical correspondent Elizabeth Cohen earlier this month.

"He went in for a routine, minimally invasive surgery" but doctors "hit his intestines," the source close to Murtha told Cohen.

The review is being conducted to determine if Murtha died due to a preventable surgical error and whether any action against those who performed the surgery is potentially warranted.

The official emphasized the review is being conducted just as it would be in other hospitals that review unexpected deaths. Procedures for such reviews are determined by the independent Joint Commission, a board of 29 people including physicians, nurses, hospital administrators and other health care experts, who spell out standards of care.

The military official said the review of the care Murtha received includes: A "mortality and morbidity conference" meeting by caregivers and other officials to review exactly what happened; a quality assurance investigation by "uninvolved" subject matter experts; a review by a "multidisciplinary patient safety committee;" consultations with Navy and outside medical experts.

As many as 500,000 gallbladder removal operations are done each year in the United States, with relatively few complications.

At most, only one out of every 1,000 patients dies during gallbladder removal, according to the American College of Surgeons. Factors that increase the risk of death include gangrene, a burst gallbladder or severe diseases.

The laparoscopic surgery is a safe, minimally invasive procedure, said Dr. L.D. Britt, president-elect of the American College of Surgeons and professor at Eastern Virginia Medical School. Out of hundreds of thousands of cases, only a handful result in damage to the intestines, he said. Precise statistics are not available.