Faculty Bibliography

The media have begun beating the stuffing out of another drug, Ambien, as they show pictures of drowsy sleepwalkers cooking or stuffing themselves at the refrigerator in the middle of the night, or write stories about the risks to motor vehicle operators. The fact is, the vast majority of the author's patients experience no side effects whatsoever. In fact, Ambien is so well tolerated and effective that it has changed the way doctors treat insomnia. Medical misinformation of this kind helps neither doctors nor their patients

PPD encompasses a wide spectrum of manifestations that are often overlooked and left untreated. The article's failure to discuss some of the most common symptoms, such as panic attacks and obsessive-compulsive thoughts and behaviors, does a grave disservice to mothers-to-be and sufferers of PPD.

The science on the H5N1 bird flu virus may not support these conclusions. Two important studies published just last month in top science journals show that this bird flu virus is still multiple mutations away from being able to pass easily among humans. This bird flu appears to be better absorbed by the deep pockets of bird lungs, whereas human flu is absorbed by the cells of our upper airways. Dr. David Swayne, director of the Southeast Poultry Laboratory at the U.S. Department of Agriculture, has worked on avian influenza for many years. He takes all highly pathogenic bird flus seriously, including H5N1, but he feels they can most often be controlled. Swayne told me that H5N1 might still be eradicated in birds with the help of 'better diagnostic tools and improved strategies to protect birds from infection.'

The science on the H5N1 bird flu virus may not support these conclusions. Two important studies published just last month in top science journals show that this bird flu virus is still multiple mutations away from being able to pass easily among humans. This bird flu appears to be better absorbed by the deep pockets of bird lungs, whereas human flu is absorbed by the cells of our upper airways. Dr. David Swayne, director of the Southeast Poultry Laboratory at the U.S. Department of Agriculture, has worked on avian influenza for many years. He takes all highly pathogenic bird flus seriously, including H5N1, but he feels they can most often be controlled. Swayne told me that H5N1 might still be eradicated in birds with the help of 'better diagnostic tools and improved strategies to protect birds from infection.'

The science on the H5N1bird flu virus may not support these conclusions. In fact, two important studies published just last month in top science journals show that this bird flu virus is still multiple mutations away from being able to pass easily among humans. This bird flu appears to be better absorbed by the deep pockets of bird lungs, whereas human flu is absorbed by the cells of our upper airways. Dr. David Swayne, director of the Southeast Poultry Laboratory at the U.S. Department of Agriculture, has worked on avian influenza for many years. He takes all highly pathogenic bird flus seriously, including H5N1, but he feels they can most often be controlled. Swayne told me that H5N1 might still be eradicated in birds with the help of 'better diagnostic tools and improved strategies to protect birds from infection.'

Dr David Katz, director of the Yale prevention research center, recently published a book, The Flavor Point Diet, in which he explores the idea that being stimulated by too many flavors stimulates more hunger. But many patients lack the discipline and do not manage to achieve a healthier lifestyle, no matter what the road map. So it is necessary to consider dietary aides. Without a perfect diet drug, many are looking with interest at Acomplia (rimonabant), a promising drug in late-stage clinical trials that works directly by blocking appetite (endocannabinoid) receptors in the brain

According to a significant study published in the prestigious British journal Nature recently, the H5N1 bird flu virus is at least two large mutations and two small mutations away from being the next human pandemic virus. This virus attaches deep in the lungs of birds but cannot adhere to the upper respiratory tract of humans. Since we can't transmit the virus to one another, it poses little immediate threat to us. Fear causes the public to blur the distinction between birds and people, and so, as the H5N1 virus infects flocks of birds in Pakistan and Israel, nightly news watchers track the path to the United States. The poultry industry cringes as migratory birds that might be carrying H5N1 make their way closer to the northern shores of North America. If H5N1 spreads in pigs (a soup of viruses) and exchanges genetic material with another human flu virus before passing to humans, the result is likely to be far less deadly. The swine flu fiasco of 1976 is an example of the damage that can be done by fear of a mutated virus that never quite lives up to 1918 expectations. About 1,000 cases of ascending paralysis occurred from a rushed vaccine given to more than 40 million people in response to a feared pandemic that never arrived

According to a significant study published in the prestigious British journal Nature recently, the H5N1 bird flu virus is at least two large mutations and two small mutations away from being the next human pandemic virus. This virus attaches deep in the lungs of birds but cannot adhere to the upper respiratory tract of humans. Since we can't transmit the virus to each other, it poses little immediate threat to us. Even if the H5N1 virus does mutate enough to spread easily among the upper breathing tracts of humans, there are multiple scenarios in which it would not cause the next massive pandemic. In fact, the Spanish flu of 1918 made the jump to humans before killing a large number of birds. Not only do we have vaccinations, antibiotics, antiviral drugs, public information networks, steroids and heart treatments that were lacking in 1918 to treat victims of the flu; in addition, the growing worldwide immunity to H5N1 may lessen the outbreak in humans even if the dreaded mutation does occur. Cooking a chicken or turkey kills any influenza virus 100 percent of the time, yet the fear of H5N1 bird flu is already so rampant in Europe that poultry consumption is down 70 percent in Italy and 20 percent in France. In Britain people are giving away their parrots after a single parrot got the disease, and in Germany a cat died of H5N1 and the public was told to keep cats indoors. Forty-six countries outside the European Union banned French poultry exports after a single flock of turkeys was found to be infected. France, fourth in the world in poultry exports, is already hemorrhaging more than $40 million a month

This scenario reads like something from our near future. Experts predict that the bird flu virus might hit our shores within a year. In fact, it's a news flash from three decades ago. The events of the so-called swine flu in the USA seem hauntingly familiar to those of us who are focused on the current bird flu, and they can serve as a useful guide on what to do now and -- perhaps as important -- what not to do. The rush to make vaccines for a flu virus to which we have no immunity is not a new concept. This is what happened during the swine flu fiasco of 1976, when the fear of another killer outbreak provoked a national political response and a rushed vaccination program. More than 40 million people received the swine flu vaccine that year against a new pig virus that ultimately never took hold. It was later determined that the swine flu wasn't as virulent or as deadly as originally thought. But more than 1,000 cases of Guillain-Barre syndrome, a life-threatening ascending paralysis, occurred in those who received the vaccine, which had been rushed into production. The public relations nightmare and lawsuits against the government helped to drive many drug companies away from making flu vaccine at all. (Of 27 companies that manufactured flu vaccines at the time, only three still do.)

[Robert Webster]'s statement is the latest Hitchcockian pronouncement about H5N1 bird flu, a virus that is deadly in birds. But humans are different. We are protected by a species barrier, and serological surveys conducted in 1997 in Hong Kong and since have detected antibodies in thousands of humans who never got sick, showing that bird flu isn't as deadly to the few who come in contact with it as has been reported. If H5N1 takes hold in pigs and exchanges genetic material with another flu virus, the result is likely to be far less deadly. The swine flu fiasco of 1976 is an example of the damage that can be done from fear of a mutated virus that can theoretically affect us. More than 1,000 cases of paralysis occurred from a rushed vaccine given to more than 40 million people in response to a pandemic that never came