Faculty Bibliography

In their vigil for a possible return of SARS, health officials have focused mainly on finding where the virus hides in nature. But the case of severe acute respiratory syndrome in a 27-year-old doctoral student in Singapore has shown an equally important risk -- escape of the virus from a laboratory. 'Inappropriate laboratory standards and a cross-contamination of West Nile virus samples with SARS coronavirus in the laboratory led to the infection of the doctoral student,' the committee reported. No additional spread occurred, preserving the disease's eradication. But the scientist in charge of the laboratory committed suicide. Now, many laboratories around the world have stored thousands of SARS specimens in freezers, ready to be thawed as needed. The WHO has cautioned China and other countries that accidents may occur in laboratories where there is little experience with dangerous infectious agents

The first report card on the United Nations' two-year-old commitment to defeat AIDS gives the world's countries generally low marks in their efforts to overcome ignorance about the disease and provide access to prevention and treatment measures, UN officials said. At the General Assembly's special session on AIDS in June 2001, UN members agreed that defeating AIDS would take commitment, resources and action

The first report card on the United Nation's 2-year-old commitment to defeat AIDS gives the world's countries generally low marks in their efforts to overcome ignorance about the disease and provide access to prevention and treatment measures, UN officials said. At the General Assembly's special session on AIDS in June 2001, UN members agreed that defeating AIDS would take commitment, resources and action. The $4.7 billion is five times the amount spent in 1996 but less than half the $10 billion required for an effective response in 2005 and one-third of what will be needed by 2007, [Peter Piot] said. In part because of inadequate funding, many countries will not meet basic goals like rapidly expanding AIDS prevention and care that were expected of them by 2005. One goal is to ensure that by 2005 at least 80 percent of pregnant women have access to information, counseling and treatment to prevent transmission of the AIDS virus. But such services remain virtually nonexistent in the countries that are worst affected by AIDS, according to the report card that Piot's agency issued here Monday

The researcher worked in a laboratory that Singapore had created to study the West Nile virus and other diseases before SARS became an epidemic earlier this year. The laboratory grew the SARS virus to provide materials for developing diagnostic tests. Because the Singapore government and the health organization's officials are deeply concerned about the possibility of SARS accidentally escaping from a laboratory, Singapore asked the health organization, a Geneva-based U.N. agency, to send an expert committee to investigate the circumstances of the researcher's case

Canadian environmental scientists invited by Hong Kong and the World Health Organization to investigate a large outbreak of SARS in an apartment complex in Hong Kong concurred with earlier findings by scientists there, Dr. [Margaret Chan] said. She said that the Hong Kong and Canadian investigators found that a collection of factors had to converge to cause the outbreak. They included: an infected individual who transmitted the illness to a dozen or so other people living in one line of apartments in the complex, diarrhea developing in at least one of the infected, and a malfunctioning of the plumbing and sewage systems. Dr. Chan said that when her department first confronted SARS in Hong Kong, ''we had no idea what we were dealing with and we did not even know it was a virus.'' But Dr. Chan said the experience taught health officials not to ''be afraid to say you don't know what you are dealing with.'' ''SARS is too big for any country to handle single-handedly,'' Dr. Chan said. ''It calls for regional and global collaboration, and the collaboration has been unprecedented in terms of identifying the virus'' and carrying out other research. The W.H.O. has been widely praised for organizing teams of laboratory scientists, epidemiologists and health officials around the world immediately after it declared SARS a global health risk on March 12

''Inappropriate laboratory standards and a cross-contamination of West Nile virus samples with SARS coronavirus in the laboratory led to the infection of the doctoral student,'' the committee reported. After the epidemic ended, the laboratory worked on the West Nile virus and SARS coronavirus at the same time. The committee said that the laboratory did not pause to review its procedures and that its record-keeping system was poor. As part of the committee's investigation, it asked Singapore scientists to thaw and test a stored vial that was supposed to contain West Nile virus only. SARS virus was also detected

If a major outbreak of SARS, or severe acute respiratory syndrome, occurred, then the system of sending specimens for independent confirmation would become less critical, said Dr. Malik Peiris of the Queen Mary Hospital in Hong Kong. W.H.O. credits Dr. Peiris with discovering the SARS coronavirus. During the epidemic, some individuals whose serums were rich with SARS antibodies had donated blood as an experimental treatment known as passive immunization for very ill SARS patients. Such donations are relatively easy to obtain because they are altruistic. But, Dr. Peiris said, ''when you talk about donating blood for diagnostic tests it seems a bit more remote.'' SARS is one of many viruses that can cause a lung condition known as atypical pneumonia, and many doctors would be likely to suspect SARS because of the epidemic earlier this year. But, Dr. [John MacKenzie] said, ''we don't want to test everyone who has atypical pneumonia unless there is a cluster of cases for which there is no other alternative diagnosis and for which antibiotics do not work.''

The countries in Africa are Mozambique, Rwanda, South Africa and Tanzania, which have about one-third of all AIDS cases there. The Caribbean nations are the Bahamas, Dominican Republic, Haiti and the Organization of Eastern Caribbean States, which includes Antigua and Barbuda; Dominica, Grenada; Saint Kitts and Nevis; St. Lucia; Saint Vincent and the Grenadines; Montserrat, Anguilla and the British Virgin Islands. More than 90 percent of Caribbean AIDS patients live in those places

All countries should conduct inventories at their laboratories to determine where the SARS virus is being kept and what strains of the virus are being stored, [John MacKenzie] said Tuesday. Also, MacKenzie said, the WHO, an agency of the United Nations, and member countries needed to develop procedures to control which laboratories can hold and work with the virus, which apparently is confined to laboratories now. The committee came up with a list of high-priority research questions for researchers, but did not release the list. In the Singapore case, a 27-year-old doctoral student accidentally became infected with SARS while working on the West Nile virus. The student did not know he had been exposed to the SARS virus

The researcher worked in a laboratory that Singapore had created to study the West Nile virus and other diseases before SARS became epidemic earlier this year. The laboratory grew the SARS virus to provide materials for developing diagnostic tests. Because the Singapore government and the health organization's officials are deeply concerned about the possibility of SARS accidentally escaping from a laboratory, Singapore asked the health organization, a United Nations agency based in Geneva, to send an expert committee to investigate the circumstances of the researcher's case