Faculty Bibliography

The sudden appearance of monkeypox in the United States is a surprise. Precisely how monkeypox reached the United States is unknown. Dr. Stephen Ostroff, a CDC official, said that the federal agency was investigating a number of theories, including an imported case in a traveler from West Africa or a sick animal. Dr. Kurt Reed, an infectious disease pathologist who runs the microbiology lab and the clinical research center at Marshfield Clinic, a large research facility in central Wisconsin, said his lab was the first to isolate the virus, after a 4-year-old girl who had been bitten by her new pet prairie dog came in with an infected finger in mid-May. That really raised the suspicion that this was an old-world virus that had made its way into the United States, Reed said. Prairie dogs, and Gambian rats, are part of a wide array of exotic animals feeding a growing niche pet market, though some animal-rights activists oppose their domestication. Prairie dogs, members of the squirrel family that are found in the Rocky Mountain west, are believed to have a sophisticated communication system. The rats, which grow to the size of small cats, eat pet food mixes as well as fruits, vegetables and cooked meats. They are intelligent, social and can be very gentle if handled from an early age, one enthusiast, Jazmyn Concolor, posted on the Web site www.altpet.net, adding that one rat sleeps with, and does not chew to death, a stuffed toy lion. They are not pets for everyone, requiring patience and understanding of their habits

Initially, health officials feared the worst from SARS - a global epidemic that could rival the 1918-19 influenza pandemic. Now, many health officials say that scenario appears unlikely and that SARS may be behind us. They express confidence that SARS can be contained. Much about SARS remains unknown. Among the questions are: How important are animals in its transmission? Is there a seasonal pattern to SARS? Will it return in stronger force next year? Because SARS is transmitted mainly from person to person, the health agency is deeply concerned that epidemiologists haven't determined the source of the virus in about half of new SARS cases in China

A major concern is the viral disease's volatility. Severe acute respiratory syndrome first erupted in Guangdong Province in China last November. Since then, SARS has been reported in more than 30 countries with unequal force. The United States and most other affected countries have prevented imported cases from spreading to other people. But across the border, in Toronto, SARS has hit with devastating force. Initially, health officials feared the worst from SARS -- a global epidemic that could rival the 1918-19 influenza pandemic. Now, many health officials say that scenario appears unlikely, that SARS may be behind us, and express confidence that SARS can be contained. Because SARS is transmitted mainly from person to person, the health agency is deeply concerned that epidemiologists have not determined the source of the virus in about half of new SARS cases in China. The health agency also wants to know what quarantine measures China is using and whether they are working better than elsewhere

This unusual feature of SARS will require highly sensitive tests, and it will probably be several months before doctors will be able to use a single test to determine whether a person must be isolated because he or she has SARS. There could also be business obstacles to developing tests. The market for such tests could be small if SARS does not remain a serious health threat. If it is found that SARS can be transmitted through blood, the market would grow because blood donations would have to be screened. Dr. [William Bellini] of the Centers for Disease Control is among those seeking a test for SARS. (Linda Spillers for The New York Times)(pg. F1); Dr. [Malik Peiris], top, and Dr. [Anthony S. Fauci] spoke at a SARS meeting in Maryland on Friday. (Photographs by Linda Spillers for The New York Times)(pg. F6)

Health officials are also investigating the possibility of a second potential new outbreak of SARS among residents of Parry Sound, a small Ontario community, after a resident there developed SARS following a visit to an affected hospital in Toronto. About 70 Parry Sound residents are in quarantine while the ill patient, who is considered a possible SARS case, is now in a Toronto hospital. At the same time, health officials were investigating the possibility that the disease has affected a fifth hospital in the Toronto area since a new wave of illness was reported on May 22, suggesting that the potential for greater spread continued

Health authorities yesterday ordered the quarantining of up to 2,000 students, teachers and workers at a large parochial school on the outskirts of Toronto that was closed after an 11th- grade student attended classes for two days last week while showing symptoms of SARS. Health officials also are investigating the possibility of a second potential new outbreak of SARS among residents of the small Ontario community of Parry Sound after a resident there developed SARS following a visit to an affected hospital in Toronto. About 70 residents of Parry Sound are in quarantine while the ill patient, considered a possible SARS case, is in a Toronto hospital. 1 PIC; Nurses at North York General Hospital in Toronto walked through a new SARS assessment clinic outside the emergency room of the hospital. The illness has spread to other area hospitals through transfers of patients from North York.; Credit: Lucas Oleniuk / Associated Press

Health officials are also investigating the possibility of a second potential new case of the disease, known formally as severe acute respiratory syndrome, among residents of the small Ontario community of Parry Sound after a resident there developed what medical authorities believed was SARS following a visit to an affected hospital in Toronto. About 70 residents of Parry Sound are in quarantine while the ill patient is now in a Toronto hospital. At the same time, health officials are investigating the possibility that the disease has affected a fifth hospital in the metropolitan Toronto area since a new wave of illness was reported last Thursday, suggesting that the potential for greater spread continued. In the new wave in Toronto, there are at least 11 probable and 23 suspected SARS cases, and the numbers are expected to rise over the next few days, health officials said. Even as Toronto officials continued to try to reassure residents and tourists that the city was safe, two elderly patients died Tuesday night from SARS, bringing the total to 29 deaths in the Toronto area in three months. During the same period, doctors have reported 262 other cases -- 118 probable and 144 suspected -- making Canada's largest city the most seriously affected place outside of Asia since the first cases occurred in Guangdong province in China last November

Last week, scientists in Hong Kong and at the Center for Disease Control in Shenzhen, in Guangdong just across the Hong Kong border, reported finding the SARS virus in three species of animals Himalayan, or masked, palm civets; raccoon dogs; and badgers bought at a food market in Shenzhen. That discovery suggested, but did not prove, that the SARS virus infects animals in the wild, making it virtually impossible to eradicate the disease. One of the two new studies involved workers at the same market in Shenzhen. Dr. Klaus Stoehr, the scientific director of WHO's investigation of SARS in Geneva, said that a team of virologists headed by Dr. Malik Peiris of Hong Kong University tested blood taken from 10 market workers and found antibodies to the SARS virus in five. Antibodies are specific proteins that the immune system forms when it mounts an attack against a microbe. Although the findings are not definitive, they strengthen the suggestion that animals play a role in transmitting SARS, Stoehr said. The findings, he said, suggest that the spectrum of disease is wider than what we saw when SARS was first detected in March as a severe form of atypical pneumonia in patients in Hanoi and Hong Kong

The World Health Organization's 192 member nations were preparing Wednesday to grant it sweeping new powers to respond to international health threats like SARS and bioterrorist attacks. Under the resolution at the organization's annual meeting in Geneva, WHO would gain the power to set up an instant communication network, tap unofficial but reliable sources of information, and send its own teams to see if countries experiencing outbreaks are doing enough to prevent threats to other countries. Early in the SARS epidemic, WHO officials used publicity to pressure the Chinese government to allow teams to investigate the disease. Although the first cases of SARS were believed to have occurred in Guangdong Province in China last November, China initially and repeatedly rebuffed the international health agency's initial requests for teams of epidemiologists and infectious disease experts to visit Guangdong

Last week, scientists in Hong Kong and at the Center for Disease Control in Shenzhen, just across the Hong Kong border in Guangdong, reported finding the SARS virus in three species of animals Himalayan palm civets, raccoon dogs and badgers at a food market in Shenzhen. That discovery suggested, but did not prove, that the virus infects animals in the wild, making it virtually impossible to eradicate the disease. One of the two new studies involved workers at the same market. Dr. Klaus Stoehr, the scientific director of WHO's investigation of SARS in Geneva, said a team of virologists headed by Dr. Malik Peiris of Hong Kong University had tested blood taken from 10 market workers and found antibodies to the SARS virus in five. Antibodies are proteins that the immune system forms when it mounts an attack against a microbe. Although the findings are not definitive, they strengthen the suggestion that animals play a role in transmitting SARS, Stoehr said. The findings, he said, suggest that the spectrum of disease is wider than what we saw when SARS was first detected in March