Faculty Bibliography

As sewage continues to spill directly into the streets of Iraq's second-largest city and the population increasingly relies on water from fetid canals, the World Health Organization warned yesterday that [BASRA] was poised for an epidemic of cholera. The disease has been endemic in Basra and most other areas of Iraq since the 1980s. A major outbreak occurred in the Basra region in 1991, after the first Persian Gulf War. At that time, the power was knocked out, incapacitating the water treatment plants that provided a relatively safe system. Half a million tons of raw sewage flowed into the rivers daily, according to the United Nations

Dr. James Crucetti, Albany County public health commissioner, said he is concerned to hear other health departments are considering cutting programs to cover smallpox vaccination costs. The [Bush] administration has requested that health departments administer smallpox vaccine to health care workers on a voluntary basis. Local health departments are responsible for giving smallpox vaccinations in two stages. In the first, which is expected to begin this month and last about 60 days, up to 500,000 civilian health care and emergency workers will be vaccinated. In the second, up to 10 million health care workers, police officers, firefighters and emergency medical technicians will be offered the vaccine. The latest demands involve a vaccine that few practicing doctors have given because the United States abandoned it as a routine in 1972, eight years before smallpox was eradicated from the world. Now health departments must train workers how to use two-pronged needles to administer the vaccine and recognize its many complications, some rare but potentially lethal

In a statement issued Tuesday, Pfizer said it had already given government researchers AG-7088, along with dozens of other antiviral compounds, to test as possible treatments for SARS. The company said some of the compounds had shown moderate activity against the virus, but [Betsy Raymond] said she did not know whether AG-7088 was among the active ones. On Sunday in Hong Kong, another researcher also reported possible progress in identifying drugs to treat SARS. Dr. David Ho, scientific director of the Aaron Diamond AIDS Research Center in New York, said at a news conference that he and his colleagues had synthesized several compounds, known as peptides, that could prevent the SARS virus from entering human cells. But Ho also said it would take years of testing before any of the drugs might be marketed

As sewage continues to spill directly into the streets of Iraq's second-largest city and the population increasingly relies on water from fetid canals, the World Health Organization has warned that Basra is poised for an epidemic of cholera. Dr. Claire-Lise Chaignat, who directs the World Health Organization's cholera program in Geneva, said, 'Once cholera starts to burst, then it is very difficult to contain.' Until an effective community water supply can be put in place, health workers are trying to teach residents to chlorinate and boil their water. The disease has been endemic in Basra and most other areas of Iraq since the 1980s. A major outbreak occurred in the Basra region in 1991, after the first Gulf War. At that time, the power was knocked out, incapacitating the water treatment plants that provided a relatively safe system. Half a million tons of raw sewage flowed into the rivers daily, according to the United Nations

''The compound itself will probably not be used for a drug to treat SARS, but is a very good starting point for designing drugs that fit better,'' he said. He added that both AG-7088 and the protease inhibitor that he and his colleagues created should be studied as possible bases for a SARS drug. Drugs that work in a similar way are used to treat AIDS. On Sunday in Hong Kong, another researcher also reported possible progress in identifying drugs to treat SARS. Dr. David Ho, scientific director of the Aaron Diamond AIDS Research Center in New York, said at a news conference that he and his colleagues had synthesized several compounds, known as peptides, that could prevent the SARS virus from entering human cells. But Dr. Ho also said it would take years of testing before any of the drugs might be marketed. The businessman died before SARS was first recognized, in Asia. After the W.H.O.'s global alert led to wide publicity, a friend of the dead man questioned whether he might have died from SARS. Nigerian officials traced his contacts, but have found no evidence of SARS, Dr. [David L. Heymann] said

As sewage continues to spill into the streets of this city, Iraq's second largest, and the local population is increasingly relying on water from fetid canals, the World Health Organization warned today that [Basra] was poised for an epidemic of cholera. At least 55 suspected cases have been reported in Basra in recent days, and Dr. Denis Coulombier, an official of the health agency here, estimated that several hundred more cases had yet to be diagnosed. There have been no deaths. Local hospitals have the ability to perform diagnostic tests for cholera. But looting and lack of security have restricted testing in the outbreak. Last week, stool samples from 17 suspected cases were sent from Basra to Kuwait for confirmation. But they arrived in such poor condition that the diagnoses could not be confirmed, said Dr. [Claire-Lise Chaignat] of the World Health Organization

Researchers at the Centers for Disease Control have developed a test like the Elisa, which is used to screen for the AIDS virus and other infectious agents. The SARS test is expected to have limited use because it cannot detect antibodies until three weeks after the onset of illness. A positive result would strongly indicate that an individual had been infected with the SARS virus, but a negative test would not necessarily rule out such infection, [Julie Gerberding] said. Dr. Earl Brown, a virologist at the University of Ottawa, said: 'I hope that SARS will change, but I'm concerned. This virus seems to be happy with the genes it's got.' Brown, in a commentary on the study in The Lancet, suggested that because the SARS virus had changed relatively little in its first few months, it seemed unlikely to mutate into a milder form

C.D.C. researchers have developed a test like the Elisa, which is used to screen for the AIDS virus and other infectious agents. The SARS test is expected to have limited use because it cannot detect antibodies until three weeks after the onset of illness. A positive result would, however, strongly indicate that someone had been infected with the SARS virus, while a negative test would not necessarily rule out such infection, Dr. [Julie L. Gerberding] said. The World Health Organization has said the SARS virus, which is a newly discovered member of the coronavirus family, is the cause of SARS. But the agency and other scientists agree that more work needs to be done to be certain. Scientists know that other coronaviruses have a high rate of mutation and so they say that it is far too soon to know whether the SARS virus will change to cause milder, or even more severe, illness, or become a seasonal disease, like influenza and other coronaviruses. Dr. [Earl G. Brown] said that studying animals in China to trace SARS back to its possible origin would be a formidable task. Countless animals would have to be swabbed for viruses, and the samples would then have to be cultured, sequenced and compared. And since it is also possible that SARS came from a mutated human coronavirus, researchers would have to search for human viruses as well

Calculating death rates for new diseases like SARS is notoriously difficult for epidemiologists, particularly if there is no definitive diagnostic test, as is the case with SARS. The final death rate will not be known until the epidemic has run its course. Moreover, death rates can vary from one set of patients to another, depending on factors like the amount of virus transmitted, where it entered the body, and the functioning of an individual's immune system. On Tuesday, the same study that found a higher death rate in Hong Kong suggested that the incubation period for SARS might be as long as 14 days. But that analysis, published in the medical journal Lancet, was based on only 57 cases. On Wednesday, the WHO stood by its 10-day estimate. That figure was determined by reviewing cases in which the patient had a single documented exposure to a known SARS patient in Canada, Europe or Singapore, the agency said

Health officials had assumed that this must be the case because of the pattern of spread in an apartment complex and hotel in Hong Kong. The new findings strengthen the theory, said Dr. Klaus Stoehr, a German virologist and epidemiologist who is the scientific director of the WHO's SARS investigation. Hong Kong officials have found that 203 people with such contacts who were in quarantine developed SARS, Stoehr said. A large proportion of them had had contact with people who were infected at Amoy Gardens, an apartment complex where a large outbreak occurred. Hong Kong officials have theorized that the outbreak resulted from a sewage leak