The U.S. Food and Drug Administration is warning that terbutaline administered by injection or through an infusion pump should not be used in pregnant women for prevention or prolonged (beyond 48-72 hours) treatment of preterm labor due to the potential for serious maternal heart problems and death. In addition, oral terbutaline tablets should not be used for prevention or treatment of preterm labor. The FDA is requiring the addition of a Boxed Warning and Contraindication to the drug prescribing information (labeling) to warn against these uses.
Terbutaline is FDA-approved to prevent and treat narrowing of the airways (bronchospasm) associated with asthma, bronchitis, and emphysema. The drug is used off-label for obstetric purposes, including treating preterm labor and treating uterine hyperstimulation. Terbutaline has also been used in an attempt to prevent recurrent preterm labor. There is no evidence, however, that use of terbutaline to prevent preterm labor improves infant outcomes. Serious adverse events, including maternal deaths, have been reported with such use in pregnant patients.
“Women should be aware that serious and sometimes fatal side effects have been reported after prolonged use of terbutaline in pregnant women,” said Scott Monroe, M.D., director of FDA’s Division of Reproductive and Urologic Products. “It is important for patients and health care professionals to consider all the potential risks and known benefits of any drug before deciding on its use.”
The FDA is aware that administration of terbutaline by injection to pregnant women is used in hospital settings in certain urgent situations. The FDA warning relates to safety concerns about the prolonged use of terbutaline injection beyond 48-72 hours, and against any use of oral terbutaline in pregnant women for prevention or treatment of preterm labor.
The decision to require a Boxed Warning and Contraindication is based on the FDA’s review of post-market safety reports of heart problems and even death associated with terbutaline use for obstetric indications, as well as data from medical literature documenting the lack of safety and effectiveness of terbutaline for preventing preterm labor, and animal data suggesting potential risks. Based on this information, the FDA concluded that the risk of serious adverse events outweighs any potential benefit to pregnant patients for either prolonged use of terbutaline injection beyond 48-72 hours or use of oral terbutaline for prevention or treatment of preterm labor.
These changes to the drug labeling are consistent with statements from the American College of Obstetricians and Gynecologists discouraging use of terbutaline for preventing preterm labor.
There are multiple generic versions of terbutaline oral tablets and injectable formulations available. The brand name products were previously discontinued by the companies that made them.
The FDA encourages patients to talk to their health care professional if they have concerns about any treatment they are receiving. Patients and health care professionals should report any side effects from the use of terbutaline to the FDA’s MedWatch adverse event reporting program at www.fda.gov/MedWatch1.
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Showing posts with label death. Show all posts
Showing posts with label death. Show all posts
Wednesday, February 23, 2011
Wednesday, December 15, 2010
FDA says Tessalon liquid cough capsules pose risk for young children
The U.S. Food and Drug Administration is warning that accidental ingestion of Tessalon (benzonatate) by children younger than 10 years can result in serious side effects or death.
Tessalon, approved by the FDA to treat symptomatic relief of cough in patients older than 10, may attract younger children because of the drug’s candy-like appearance – a round, liquid-filled gelatin capsule. The safety and effectiveness of benzonatate in children younger than 10 years has not been established.
“Benzonatate should be kept in a child-resistant container and stored out of reach of children," said Carol Holquist, R.Ph., director of FDA’s Division of Medication Error Prevention and Analysis. “The FDA encourages health care professionals to talk with their patients and those caring for children about the risk of accidental ingestion or overdose.”
A review of the FDA’s Adverse Event Reporting System database from 1982 through May 2010 identified seven cases of accidental ingestion associated with benzonatate in children younger than 10. Five of the cases resulted in death in children ages 2 years and younger. Overdose with benzonatate in children younger than 2 years has been reported following accidental ingestion of only one or two benzonatate capsules.
Common adverse events reported in the overdose cases included cardiac arrest, coma, and convulsion. Signs and symptoms of overdose can occur within 15-20 minutes of ingestion. Some of the deaths reported in children have been within hours of the accidental ingestion.
The FDA is also adding a new Warning and Precaution section to the benzonatate drug label to warn health care professionals about accidental ingestion resulting in overdose and death in children younger than 10.
Consumers and health care professionals are encouraged to report adverse side effects or medication errors from the use of benzonatate to the FDA's MedWatch Adverse Event Reporting program at www.fda.gov/MedWatch or by calling 800-332-1088.
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Tessalon, approved by the FDA to treat symptomatic relief of cough in patients older than 10, may attract younger children because of the drug’s candy-like appearance – a round, liquid-filled gelatin capsule. The safety and effectiveness of benzonatate in children younger than 10 years has not been established.
“Benzonatate should be kept in a child-resistant container and stored out of reach of children," said Carol Holquist, R.Ph., director of FDA’s Division of Medication Error Prevention and Analysis. “The FDA encourages health care professionals to talk with their patients and those caring for children about the risk of accidental ingestion or overdose.”
A review of the FDA’s Adverse Event Reporting System database from 1982 through May 2010 identified seven cases of accidental ingestion associated with benzonatate in children younger than 10. Five of the cases resulted in death in children ages 2 years and younger. Overdose with benzonatate in children younger than 2 years has been reported following accidental ingestion of only one or two benzonatate capsules.
Common adverse events reported in the overdose cases included cardiac arrest, coma, and convulsion. Signs and symptoms of overdose can occur within 15-20 minutes of ingestion. Some of the deaths reported in children have been within hours of the accidental ingestion.
The FDA is also adding a new Warning and Precaution section to the benzonatate drug label to warn health care professionals about accidental ingestion resulting in overdose and death in children younger than 10.
Consumers and health care professionals are encouraged to report adverse side effects or medication errors from the use of benzonatate to the FDA's MedWatch Adverse Event Reporting program at www.fda.gov/MedWatch or by calling 800-332-1088.
-----
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Wednesday, September 08, 2010
Low Carb Diet Rich in Animal Fat and Protein Increases Risk of Death
/PRNewswire/ -- Those who adhered to a diet low in carbohydrates but rich in animal-based fats and proteins increased their risk of death - especially by cancer, according to a study published in the Annals of Internal Medicine, led by Simmons College nutrition professor Teresa Fung, Sc. D.
This study is the first of its kind to demonstrate the link between different types of low carbohydrate diets and mortality. It also sought to determine the long-term impact of low carbohydrate diets, which have been promoted as an effective option for weight loss and improving health.
Conversely, the study found that a diet low in carbohydrates but rich in plant-based fats and proteins was associated with a lower risk of mortality.
Fung, who teaches at the Simmons College School of Health Sciences, led the study with colleagues at the Harvard School of Public Health and Channing Laboratory, Brigham and Women's Hospital.
"This research indicates that all low carb diets are not the same, and the differences have an indelible impact," Fung said. "One that is based on plant foods is a better choice than one that is based on animal foods."
The study is based on two cohorts of participants: more than 85,000 women enrolled in the Nurse's Health Study (ages 34 to 59) who provided dietary information for 26 years; and more than 44,500 men enrolled the Health Professional's Follow Up Study (ages 40 to 75) who provided dietary information for 20 years. All participants included in the study were free of heart disease, cancer or diabetes. The Nurses' Health Study is based at Channing Laboratory, Brigham and Women's Hospital and the Health Professionals' Follow-up Study is based at Harvard School of Public Health.
In determining health risk, the study created low carbohydrate scores for the women and men, based on a multi-year evaluation of their diet intake with a focus on the proportion of carbohydrates, and fat and protein - whether derived largely from animal or vegetable-based sources.
During follow ups with the men and women, the study found that those who had a diet made up of more animal-based sources and a low-carbohydrate intake , scored higher for association with "all-cause" mortality and cancer mortality., Those who had a diet made up of more plant-based sources and a low-carbohydrate intake, scored lower for association with "all-cause" mortality, and cancer and cardiovascular mortality.
Participants with a higher animal low carbohydrate score were heavier and were more likely to be smokers, whereas those with a higher vegetable low carbohydrate score consumed more alcohol and whole grains. Variations in lifestyle and other dietary issues, such as smoking status, family history of colorectal cancer, aspirin use, and history of hypertension were controlled in the analyses.
The National Institutes of Health funded the study, "Low-Carbohydrate Diets and All-Cause and Cause-Specific Mortality: Two Cohort Studies."
-----
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This study is the first of its kind to demonstrate the link between different types of low carbohydrate diets and mortality. It also sought to determine the long-term impact of low carbohydrate diets, which have been promoted as an effective option for weight loss and improving health.
Conversely, the study found that a diet low in carbohydrates but rich in plant-based fats and proteins was associated with a lower risk of mortality.
Fung, who teaches at the Simmons College School of Health Sciences, led the study with colleagues at the Harvard School of Public Health and Channing Laboratory, Brigham and Women's Hospital.
"This research indicates that all low carb diets are not the same, and the differences have an indelible impact," Fung said. "One that is based on plant foods is a better choice than one that is based on animal foods."
The study is based on two cohorts of participants: more than 85,000 women enrolled in the Nurse's Health Study (ages 34 to 59) who provided dietary information for 26 years; and more than 44,500 men enrolled the Health Professional's Follow Up Study (ages 40 to 75) who provided dietary information for 20 years. All participants included in the study were free of heart disease, cancer or diabetes. The Nurses' Health Study is based at Channing Laboratory, Brigham and Women's Hospital and the Health Professionals' Follow-up Study is based at Harvard School of Public Health.
In determining health risk, the study created low carbohydrate scores for the women and men, based on a multi-year evaluation of their diet intake with a focus on the proportion of carbohydrates, and fat and protein - whether derived largely from animal or vegetable-based sources.
During follow ups with the men and women, the study found that those who had a diet made up of more animal-based sources and a low-carbohydrate intake , scored higher for association with "all-cause" mortality and cancer mortality., Those who had a diet made up of more plant-based sources and a low-carbohydrate intake, scored lower for association with "all-cause" mortality, and cancer and cardiovascular mortality.
Participants with a higher animal low carbohydrate score were heavier and were more likely to be smokers, whereas those with a higher vegetable low carbohydrate score consumed more alcohol and whole grains. Variations in lifestyle and other dietary issues, such as smoking status, family history of colorectal cancer, aspirin use, and history of hypertension were controlled in the analyses.
The National Institutes of Health funded the study, "Low-Carbohydrate Diets and All-Cause and Cause-Specific Mortality: Two Cohort Studies."
-----
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Thursday, August 19, 2010
U.S. Appeals Court Reinstates Claim That Controversial Diet Drug Redux Should Never Have Been Offered to American People
/PRNewswire/ -- An Ohio Federal Court of Appeals ruling issued yesterday is reinstating the late victim's claim that the recalled diet drug Redux (commonly called fen-phen) linked to her death should never have been marketed to the American people by Wyeth due in part to its pre-approval concerns about potentially lethal side effects. The Court, in remanding the case to the trial court, held that Federal drug regulations do not preempt Ohio negligence claims, and indicated that the Supreme Court's 2009 landmark pharmaceutical manufacturer preemption decision (Wyeth v. Levine) may apply beyond inadequate warning-label claims.
Benjamin H. Anderson, Esq., of Anderson Law Offices, LLC of Cleveland, Ohio, counsel for the plaintiff, said, "Mary Buchanan, like so many others, turned to a drug to help her lose weight and as a result she lost her life. She and her surviving family members deserve justice; this is an important decision in her case and for the harms and losses she sustained, as well as the many millions of Americans taking prescription medications who have long been concerned about drug companies being shielded from appropriate state negligence laws. Significantly, the appeals court has also reinstated and remanded to the trial court our claim for punitive damages."
In reversing key sections of the trial court's finding for the defendant on summary judgment in Wimbush v. Wyeth et.al., 6th Cir. No. 09-3380, the three-judge appeals panel held that the trial judge erred in concluding that the U.S. Food and Drug Administration (FDA) preempted the Buchanan family's negligence claims that the drug should never have been made available to Americans given Wyeth-Redux's known health risks, particularly Primary Pulmonary Hypertension (PPH). Mrs. Buchanan, a hard-working and dedicated 66- year-old nurse from Maple Heights, Ohio who took the weight-loss drug during 1996 and 1997, lost her life to PPH in 2003 within a few months after filing the complaint. The drug company, which spent more than $50 million marketing the wildly popular and profitable drug after its launch in April 1996, pulled it on September 15, 1997 at the request of the FDA and under mounting criticism by independent researchers and reports in respected medical journals.
Though Redux was only on the market for a relatively short period, to date it is estimated that Wyeth has paid thousands of victims of Redux and its predecessor, Pondimin - and/or their survivors - more than $20 billion in damages. In evaluating the potential side effects of Redux, researchers noted that PPH is a devastating pulmonary disease for which there is still no cure, and the associated heart-valve problems may and often did require high-risk heart surgery. The controversial, high-risk diet drug had previously been evaluated and pulled from pharmacies overseas and it was banned in some individual states before the total recall.
In its decision, the appeals Court stated, "...we are not persuaded that it is always impossible to comply with both state law duties and FDA regulations in the process leading up to FDA approval." It added, "...we cannot agree with the district court's conclusion as, not only is there a presumption against preemption, but the case law supports the conclusion that Congress did not intend to preempt state tort law claims when it passed the Food, Drug, and Cosmetics Act (FDCA)."
In a footnote, it commented "...the overwhelming take-away from the Levine majority opinion is that state tort law has historically played a substantial role in the regulation of drug manufacturers and that Congress has never indicated an intent to change this role. Thus, while Levine did leave open the possibility that there may be some state law claims that would conflict with the FDA's regulatory authority and function, the claim at issue in Levine was not one of them. We do not believe that Buchanan's pre-approval negligence claims are, either."
Attorney Anderson, commenting on the interpretation of the Levine ruling in the case, said, "Drug companies are now on notice that they cannot lie to and conceal from the FDA crucial information in the pre-approval process and then expect to be held harmless once their drugs are responsible for causing pain, suffering and, as in Mrs. Buchanan's case, death."
The Court affirmed the dismissal of the balance of the plaintiff's claims, and Attorney Anderson said he will evaluate with appellate counsel Paul Flowers, Esq., and Mrs. Buchanan's family all appropriate legal options.
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Benjamin H. Anderson, Esq., of Anderson Law Offices, LLC of Cleveland, Ohio, counsel for the plaintiff, said, "Mary Buchanan, like so many others, turned to a drug to help her lose weight and as a result she lost her life. She and her surviving family members deserve justice; this is an important decision in her case and for the harms and losses she sustained, as well as the many millions of Americans taking prescription medications who have long been concerned about drug companies being shielded from appropriate state negligence laws. Significantly, the appeals court has also reinstated and remanded to the trial court our claim for punitive damages."
In reversing key sections of the trial court's finding for the defendant on summary judgment in Wimbush v. Wyeth et.al., 6th Cir. No. 09-3380, the three-judge appeals panel held that the trial judge erred in concluding that the U.S. Food and Drug Administration (FDA) preempted the Buchanan family's negligence claims that the drug should never have been made available to Americans given Wyeth-Redux's known health risks, particularly Primary Pulmonary Hypertension (PPH). Mrs. Buchanan, a hard-working and dedicated 66- year-old nurse from Maple Heights, Ohio who took the weight-loss drug during 1996 and 1997, lost her life to PPH in 2003 within a few months after filing the complaint. The drug company, which spent more than $50 million marketing the wildly popular and profitable drug after its launch in April 1996, pulled it on September 15, 1997 at the request of the FDA and under mounting criticism by independent researchers and reports in respected medical journals.
Though Redux was only on the market for a relatively short period, to date it is estimated that Wyeth has paid thousands of victims of Redux and its predecessor, Pondimin - and/or their survivors - more than $20 billion in damages. In evaluating the potential side effects of Redux, researchers noted that PPH is a devastating pulmonary disease for which there is still no cure, and the associated heart-valve problems may and often did require high-risk heart surgery. The controversial, high-risk diet drug had previously been evaluated and pulled from pharmacies overseas and it was banned in some individual states before the total recall.
In its decision, the appeals Court stated, "...we are not persuaded that it is always impossible to comply with both state law duties and FDA regulations in the process leading up to FDA approval." It added, "...we cannot agree with the district court's conclusion as, not only is there a presumption against preemption, but the case law supports the conclusion that Congress did not intend to preempt state tort law claims when it passed the Food, Drug, and Cosmetics Act (FDCA)."
In a footnote, it commented "...the overwhelming take-away from the Levine majority opinion is that state tort law has historically played a substantial role in the regulation of drug manufacturers and that Congress has never indicated an intent to change this role. Thus, while Levine did leave open the possibility that there may be some state law claims that would conflict with the FDA's regulatory authority and function, the claim at issue in Levine was not one of them. We do not believe that Buchanan's pre-approval negligence claims are, either."
Attorney Anderson, commenting on the interpretation of the Levine ruling in the case, said, "Drug companies are now on notice that they cannot lie to and conceal from the FDA crucial information in the pre-approval process and then expect to be held harmless once their drugs are responsible for causing pain, suffering and, as in Mrs. Buchanan's case, death."
The Court affirmed the dismissal of the balance of the plaintiff's claims, and Attorney Anderson said he will evaluate with appellate counsel Paul Flowers, Esq., and Mrs. Buchanan's family all appropriate legal options.
-----
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Wednesday, October 01, 2008
CPSC Reminds Parents of Drowning Dangers Inside the Home - Nearly 100 reported deaths of children in buckets
Water anywhere can be a potential drowning hazard. While pools are an obvious risk, parents should not let their guard down around other hazards such as bathtubs and buckets. The U.S. Consumer Product Safety Commission (CPSC) is warning parents that children need to be supervised around these common but sometimes hidden drowning dangers.
After pools, more children drown in bathtubs than in any other product in and around the home. From 2002 through 2004, CPSC has reports of 221 children younger than 5 who drowned in bathing-related incidents. Most of these children were younger than 2 years old. Often these incidents involve caregivers leaving the room momentarily to answer the phone/door or to retrieve an item like a towel. In other incidents, an older sibling was left to watch a younger sibling.
Reported drowning incidents received by CPSC confirms another drowning hazard - buckets. CPSC has reports of 94 bucket-related drowning or submersion fatalities from 1999 through 2006. All but one of these deaths were to children less than 2 years old.
"A child can drown very quickly in only inches of water," said CPSC Acting Chairman Nancy Nord. "Bathtubs, buckets, and other containers in and around the home pose drowning hazards all year long."
CPSC recommends parents and caregivers follow these safety tips when children are around bathtubs, buckets, spas, or decorative ponds or fountains:
Never leave young children alone even for a moment near any water. Young children can drown in even small amounts of water.
Always keep a young child within arm's reach in a bathtub. If you must leave, take the child with you. Never leave to answer the phone, answer the door, get a towel or for any other reason.
Don't leave a baby or toddler in a bathtub under the care of another young child.
Never leave a bucket containing even a small amount of liquid unattended. Toddlers can fall headfirst into buckets and drown. After using a bucket, always empty and store it where young children cannot reach it. Don't leave buckets outside where they can collect rainwater.
Prevent children from gaining access to spas or hot tubs when not in use; always secure with safety covers and barriers.
Learn CPR (cardiopulmonary resuscitation). It can be a lifesaver when there are only seconds to act.
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After pools, more children drown in bathtubs than in any other product in and around the home. From 2002 through 2004, CPSC has reports of 221 children younger than 5 who drowned in bathing-related incidents. Most of these children were younger than 2 years old. Often these incidents involve caregivers leaving the room momentarily to answer the phone/door or to retrieve an item like a towel. In other incidents, an older sibling was left to watch a younger sibling.
Reported drowning incidents received by CPSC confirms another drowning hazard - buckets. CPSC has reports of 94 bucket-related drowning or submersion fatalities from 1999 through 2006. All but one of these deaths were to children less than 2 years old.
"A child can drown very quickly in only inches of water," said CPSC Acting Chairman Nancy Nord. "Bathtubs, buckets, and other containers in and around the home pose drowning hazards all year long."
CPSC recommends parents and caregivers follow these safety tips when children are around bathtubs, buckets, spas, or decorative ponds or fountains:
Never leave young children alone even for a moment near any water. Young children can drown in even small amounts of water.
Always keep a young child within arm's reach in a bathtub. If you must leave, take the child with you. Never leave to answer the phone, answer the door, get a towel or for any other reason.
Don't leave a baby or toddler in a bathtub under the care of another young child.
Never leave a bucket containing even a small amount of liquid unattended. Toddlers can fall headfirst into buckets and drown. After using a bucket, always empty and store it where young children cannot reach it. Don't leave buckets outside where they can collect rainwater.
Prevent children from gaining access to spas or hot tubs when not in use; always secure with safety covers and barriers.
Learn CPR (cardiopulmonary resuscitation). It can be a lifesaver when there are only seconds to act.
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Friday, July 11, 2008
Class Action Charges Botox Killed, Injured Consume
TT Note: We've always wondered about potential dangers with the popular use of botox injections. This story really made the hair on our heads stand up. We knew you'd want to read it as well.
Botox users and their families have filed a class action lawsuit against Allergan, claiming the company failed to adequately warn users of the drug's dangers....
Read the story.
Botox users and their families have filed a class action lawsuit against Allergan, claiming the company failed to adequately warn users of the drug's dangers....
Read the story.
Friday, January 04, 2008
Two British Women Die From Identical Infection After Giving Birth on Same Day at Same Hospital
Fox News: In what is being called more than a coincidence, two new mothers who gave birth at the same British hospital on Dec. 21 died afterwards from identical infections, The Daily Mail reports.
Within 72 hours both women died from complications linked to streptococcus A infection, which normally causes sore throats.
The Daily Mail identifies the women as Amy Kimmance, 39, and Jasmine Pickett, 29.
http://www.foxnews.com/story/0,2933,320106,00.html
Original Story, Great Britain:
Two new mothers die of identical bug after giving birth at SAME hospital on SAME day
Two mothers have died from an identical infection after giving birth at the same hospital on the same day.
http://www.dailymail.co.uk/pages/live/articles/health/healthmain.html?in_article_id=505949&in_page_id=1774&ct=5
Quotes from various sources (linked below):
- Is group A strep infection an emerging infectious disease?
Yes. Health problems associated with strep A bacteria are not new, but reports of fatal infection with invasive strep A bacteria have been increasingly recognized in the United States since 1987. Researchers do not know why the new strain of strep A is on the increase or why it targets certain otherwise healthy people.
- Group A streptococci (hemolytic Streptococcus pyogenes) cause a broad spectrum of diseases, ranging from simple and uncomplicated pharyngitis and skin infection to life-threatening invasive illness that includes pneumonia, bacteraemia, necrotizing fasciitis, streptococcal toxic shock syndrome (TSS), and nonsuppurative sequelae such as acute rheumatic fever and glomerulonephritis.
- It has recently been estimated that there currently are more than 18 million cases of severe group A streptococcal disease such as rheumatic heart disease in the world, with more than 500 000 deaths each year.
Here's some links to info on Streptococcus A:
Streptococcus A - Necrotizing Fascitis, http://www.emergency.com/strep-a.htm (1994)
Group A Streptococcus - http://www.dhpe.org/infect/strepa.html
Group A streptococcal infection - http://en.wikipedia.org/wiki/Group_A_streptococcal_infection
World Health Organization - http://www.who.int/immunization/topics/strep_a/en/index.html
Within 72 hours both women died from complications linked to streptococcus A infection, which normally causes sore throats.
The Daily Mail identifies the women as Amy Kimmance, 39, and Jasmine Pickett, 29.
http://www.foxnews.com/story/0,2933,320106,00.html
Original Story, Great Britain:
Two new mothers die of identical bug after giving birth at SAME hospital on SAME day
Two mothers have died from an identical infection after giving birth at the same hospital on the same day.
http://www.dailymail.co.uk/pages/live/articles/health/healthmain.html?in_article_id=505949&in_page_id=1774&ct=5
Quotes from various sources (linked below):
- Is group A strep infection an emerging infectious disease?
Yes. Health problems associated with strep A bacteria are not new, but reports of fatal infection with invasive strep A bacteria have been increasingly recognized in the United States since 1987. Researchers do not know why the new strain of strep A is on the increase or why it targets certain otherwise healthy people.
- Group A streptococci (hemolytic Streptococcus pyogenes) cause a broad spectrum of diseases, ranging from simple and uncomplicated pharyngitis and skin infection to life-threatening invasive illness that includes pneumonia, bacteraemia, necrotizing fasciitis, streptococcal toxic shock syndrome (TSS), and nonsuppurative sequelae such as acute rheumatic fever and glomerulonephritis.
- It has recently been estimated that there currently are more than 18 million cases of severe group A streptococcal disease such as rheumatic heart disease in the world, with more than 500 000 deaths each year.
Here's some links to info on Streptococcus A:
Streptococcus A - Necrotizing Fascitis, http://www.emergency.com/strep-a.htm (1994)
Group A Streptococcus - http://www.dhpe.org/infect/strepa.html
Group A streptococcal infection - http://en.wikipedia.org/wiki/Group_A_streptococcal_infection
World Health Organization - http://www.who.int/immunization/topics/strep_a/en/index.html
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