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Mark Costello told health advocates it could still take years for a tobacco tax increase to win enough support in the Senate

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Although OM is a multifactorial disease involving Eustachian tube (ET) dysfunction, allergy, upper respiratory infection, and various environmental factors, the primary cause is bacterial infection of the middle ear (ME) mainly by Streptococcus pneumoniae , non-typeable Haemophilus influenzae (NTHi), or Moraxella catarrhalis 4