Faculty Bibliography

Gro Harlem Brundtland said she would not run for re-election next year as director general of the World Health Organization. Dr

One of the four recipients died about four weeks after the transplant. Pathology tests show the recipient had encephalitis, or inflammation of the brain and central nervous system. Tests are planned to determine if the recipient was infected with West Nile virus, which can cause encephalitis. On Friday, Dr. Julie L. Gerberding, the director of the CDC, said that 'transmission of the West Nile virus through blood and organs is biologically plausible' and that 'a leading hypothesis that we are investigating is that it is related to the organ transplant.' Meanwhile, scientists at the CDC are conducting laboratory tests on the organ donor's brain for evidence of West Nile virus or a closely related virus

If health officials confirm that the man acquired the infection through the organ transplant or a blood transfusion, it would be a new route of transmission of West Nile virus. The possibility that the man acquired his infection through the known means, a mosquito bite, has not been ruled out, officials said. No case of transmission of West Nile or closely related mosquito-borne virus through blood or organ transplants has been reported in this country, a spokesman for the Centers for Disease Control and Prevention in Atlanta said. The West Nile virus was first detected in this hemisphere in 1999, in New York City. Dr. Julie L. Gerberding, the director of the disease centers, said, ''We have to take this case seriously and have an open mind about the possibility because transmission of the West Nile virus through blood and organs is biologically plausible.'' The C.D.C. is responsible for protecting the public's health from infections like West Nile fever

The researchers exposed the cells to vaccinia virus, a relative of the smallpox virus used since the 18th century as a smallpox vaccine. The degree of the immune system cells' response to the virus offers a rough indication of immunity, the researchers said. The researchers said the participants could not recall how many times they had been vaccinated. Four study participants had last received smallpox vaccinations within five years, according to federal guidelines because they worked with the vaccination virus. Nine others were vaccinated from six to 35 years earlier. The researchers said the samples from all 13 vaccinated participants showed a robust immune response

The researchers exposed the cells to vaccinia virus, a relative of the smallpox virus used since the 18th century as a smallpox vaccine. The degree to which the immune system cells responded to the virus offers a rough indication of immunity, the researchers said. The researchers said the participants could not recall how many times they had been vaccinated. Four of the participants in the North Carolina study had last received smallpox vaccinations within five years according to federal guidelines because they worked with the vaccination virus. Nine others were vaccinated from 6 to 35 years earlier. The researchers said the samples from all 13 vaccinated participants showed a robust immune response. Another author of the textbook, Dr. D. A. Henderson, who led the health organization's smallpox eradication effort and who is now a top government adviser on bioterrorism, said he had ''no idea'' how the new findings correlated with protection against natural exposure to smallpox. Dr. Henderson said it was ''perfectly obvious that one successful vaccination does not protect for a lifetime.''

His team's findings support the growing view that oncologists continue to prescribe chemotherapy for too many cancer patients when clinical evidence indicates they are in the terminal stages of the disease. There are no guidelines for the appropriate use of chemotherapy at the end of life based on scientifically controlled trials or consensus statements, [Ezekiel Emanuel] said. The researchers used standard textbooks to classify whether different cancers were generally responsive or unresponsive to chemotherapy. Responsive cancers included in the study were breast, colon and ovarian. Unresponsive cancers included gallbladder, kidney, liver, pancreatic and melanoma. This summer, [Michael Glantz] will start work at the Barrow Institute in Phoenix, and he said his team would begin studies to determine whether marriage counseling or other types of counseling can help patients with brain tumors and their spouses cope with the disease. Depression and fatigue are frequent problems of patients undergoing chemotherapy, and a common notion among cancer doctors is that they are linked. But in a study by Dr. Gary Morrow's team from the University of Rochester Cancer Center, they were found not to be linked

The researchers used standard textbooks to classify whether different cancers were generally responsive to chemotherapy. Responsive cancers included in the study were breast, colon and ovarian. Unresponsive cancers included gallbladder, kidney, liver, pancreatic and melanoma. Additional studies are needed to confirm such findings nationally and to develop guidelines for when chemotherapy should be stopped in terminal cases, [Ezekiel Emanuel] said. He also urged studies to determine how much managed care and traditional fee-for-service practices influenced the timing of chemotherapy. [Gary Morrow]'s team found that although a drug on the market, Paxil, could relieve depression among cancer patients receiving chemotherapy, it failed to relieve symptoms of fatigue. 'While the study does not totally disprove the theory, it certainly casts doubt on it,' Morrow said

[Ezekiel J. Emanuel]'s team from Boston University and Stanford University used standard textbooks to classify whether different cancers were generally responsive or unresponsive to chemotherapy. Responsive cancers included in the study were breast, colon and ovarian. Unresponsive cancers included gall bladder, kidney, liver, pancreatic and melanoma

Bioterrorism was a main reason that Dr. Katherine A. Feldman's team from the C.D.C. was summoned to investigate five cases of rabbit fever pneumonia on Martha's Vineyard last summer. One man had died. Rabbit fever, or tularemia, is caused by a bacterium that usually is transmitted by ticks and by handling animal carcasses. But the bacterium is ranked high on the list of biological warfare agents in part because inhaling the microbe is particularly dangerous and the death rate is high if antibiotics are not started early. Health officials were puzzled when four men who developed typhoid fever in Cincinnati reported no foreign travel or common meals. Through interviews Dr. [Megan E. Reller]'s team learned that the men were gay. By reviewing hospital records and alerting health officials in other states, the epidemiologists identified a total of nine cases in Cincinnati and Indianapolis. They found that one man was a typhoid carrier and that seven of the other eight patients said they had sexual relations with him before becoming ill. Dr. Reller's team concluded that the men acquired typhoid through fecal-oral transmission during sex. The allergist then looked up articles that pointed Dr. [John T. Redd]'s team to exposure to caterpillars of the Douglas fir tussock moth (Orgyia pseudotsugata) that are widely distributed through the western United States. Dr. Redd's investigation showed that the allergic reactions occurred more commonly at certain camp sites, affecting as many as 55 percent of the scouts. For a number of reasons, Dr. Redd's team is advising the scouts not to play a game in which they they put caterpillars on the forearm, allow them to crawl on to the index finger, then flick the insects into a fire

Dr. [Kevin L. Winthrop] said spot checks of other nail salons elsewhere in California showed that the microbe was present in the vast majority of footbaths. Although only one nail salon customer outside Watsonville, a San Diego woman, is known to have been infected with the microbe, Dr. Winthrop and Dr. Ben Werner of the California health department said they strongly suspected that other outbreaks would occur. Dr. Winthrop said his team discovered whirlpool footbaths used in pedicures were teeming with M. fortuitum. By summer, Dr. Winthrop said, California officials are expected to issue regulations for rigorous cleaning and disinfection of footbaths in nail salons. M. fortuitum and its bacteriological cousins are often found in potable water and are ubiquitous elsewhere in the environment. Although the microbe has occasionally caused infections among patients with traumatic injuries, the Watsonville outbreak was the first spread in a community, Dr. Winthrop told the 50th annual meeting of the Epidemic Intelligence Service at the centers