In 2011 the United States major health news

USATODAY's Liz Szabo and Elizabeth Weise recap the year's top health stories from food-borne illnesses to the debate over graphic new warnings on cigarette labels.Sometimes less can be more. Sometimes not.

In many ways doctors and patients took a "less is more" approach to medical care and screening in 2011 though not always intentionally. Experts took a second look at the value of prostate screening and treatment as well as the safety and effectiveness of blockbuster drugs. Some families questioned routine childhood vaccinations a trend that contributed to outbreaks of measles and other infectious diseases.

•Prostate cancer: Watch and wait. The U.S. Preventive Services Task Force an independent group that advises the government on screening is no stranger to controversy. It caused an uproar two years ago by recommending fewer women get routine mammograms. In October the group said healthy men should no longer get PSA tests to screen for prostate cancer because they don't save lives but do lead to side effects such as impotence and incontinence.

A separate panel of experts convened by the National Institutes of Health concluded that many men diagnosed with early prostate cancer could safely delay treatment or avoid it altogether opting to be followed closely instead. The panel's report this month noted that most prostate cancers grow too slowly to ever threaten a man's life.

•Avastin revoked for breast cancer. In November the FDArevoked the approval of Avastin for breast cancer. Some women believe the drug has helped them but doctors say they have no way to tell which women will benefit from the $88 000 drug and which will be harmed. FDA commissioner Margaret Hamburg said the blockbuster drug which is still approved for other cancers doesn't help breast cancer patients live longer but it increases the risk of serious side effects such as bleeding and high blood pressure.

•A return of measles. The USA saw its largest measles outbreak in 15 years with more than 220 cases — nearly all in unvaccinated people the CDC said. Outbreaks were spread by unvaccinated people returning from places with high measles rates such as Europe which reported more than 26 000 cases and nine deaths by October. More than 10% of parents skip or delay shots for their children because of misplaced fears about autism or other safety concerns an October study in Pediatrics found. Studies continue to show that vaccines are safe especially when weighed against the diseases they prevent.

In March the Supreme Court upheld the Vaccine Injury Compensation Program set up in 1986 to protect the vaccine supply. It compensates people harmed by a vaccine but doesn't allow them to individually sue vaccine makers.

•Limited availability for certain prescription drugs. The FDA reported shortages of more than 200 prescription drugs this year. Cancer patients described having to use less effective substitutes while some who needed surgery had to delay their procedures. Most hard-to-find medications were older injectable drugs which are more complicated to manufacture store and ship than pills or tablets the FDA said.

In November President Obama signed an executive order expanding the FDA's authority to require drugmakers to report situations that could lead to shortages.

•HPV shots - for boys too. A vaccine to prevent infection with HPV the human papillomavirus was approved in 2006. But the shots made headlines in September when Rep. Michelle Bachmann (R-Minn.) suggested — inaccurately — in a Republican presidential debate that they could cause mental retardation.

In October a CDC advisory panel recommended the shots be given to all 11- and 12-year-olds. HPV can be spread by oral sex and vaccinating boys can protect their partners from infection panelists said. Experts also noted that HPV causes a growing number of cancers in boys and men including tumors of the anus head and neck.

•Salmonella from ground turkey. One of the largest recalls in U.S. history had its beginning in late February when health officials began to notice an increase in cases of salmonella. By July they linked what had become 77 illnesses in 26 states to ground turkey but they still didn't know the source.

The case was finally cracked via a surprising route. A national routine sampling program turned up five ground turkey samples that tested positive for a resistant strain of salmonella — the same strain that was sickening people across the country. It was only then that the Centers for Disease Control and Prevention and U.S. Department of Agriculture were able to track the turkey back to a Cargill plant in Springdale Ark. On Aug. 3 Cargill Meat Solutions announced it was recalling almost 36 million pounds of ground turkey products possibly contaminated with a multi-drug-resistant strain of Salmonella Heidelberg.

By Sept. 13 136 people in 36 states had been stricken ill and one in California had died. The hospitalization rate was 39% high for salmonella the CDC said.

Symptoms include diarrhea stomach cramps and fever within eight to 72 hours of eating tainted food plus chills headache nausea and vomiting lasting up to seven days. In some people it is life-threatening.

•Listeria in cantaloupes. A string of 29 deaths and at least 139 illnesses made an outbreak of listeria in cantaloupe the nation's deadliest illness outbreak since 1924. It came from Rocky Ford-brand cantaloupes sold by Jensen Farms near Holly Colo.

The first illnesses began after July 31; the cantaloupes were recalled Sept. 14. Symptoms of listeriosis can take up to two months to develop in someone who has eaten contaminated food which made the outbreak difficult to track. The Food and Drug Administration said it found listeria throughout the packing facility of the Colorado farm.

Citing the CDC's computerized outbreak reports and public health textbooks Robert Tauxe deputy director of CDC's Division of Foodborne Waterborne and Environmental Diseases had to go back to 1924 to find a deadlier outbreak. That one in oysters from New York City killed about 150 people and sickened more than 1 500. It was the deadliest recorded in U.S. history.

•Graphic warnings on cigarette labels? The FDA created nine graphic pictures of the health dangers of smoking and required cigarette companies to use them. A federal judge halted it but the Obama administration is appealing. Tobacco is the leading cause of preventable deaths in the USA and accounts for one in five deaths every year.

Controlling AIDS

A groundbreaking study on HIV prevention reported that early treatment with antiretroviral therapy reduced HIV sexual transmission in couples by at least 96%. The research by Myron Cohen of the University of North Carolina-Chapel Hill was hailed by U.S. and international organizations as proof that widespread treatment of HIV also prevents its transmission — meaning that for the first time there is hope of getting the global AIDS epidemic under control.