Faculty Bibliography

ATLANTA - The U.S. government has begun taking steps to cope with the possibility of a terrorist attack involving smallpox by training doctors to recognize the disease and by vaccinating small teams of experts who would rush to any part of the country to contain and treat a suspected outbreak. Tens of millions of Americans under the age of 30 are susceptible to smallpox because they were never vaccinated; the United States and Canada both stopped smallpox immunizations in 1972. Tens of millions of older people who were vaccinated decades ago are thought to have decreased protection because the vaccine may have worn off. Baffled U.S. investigators have said that despite more than 1,000 leads, they are no closer to finding out who is responsible for the deadly mail assault that started after the Sept. 11 airplane attacks on the United States

Dr. [Bruce G. Weniger] searched the National Library of Medicine's information base for scientific articles concerning the potential use of animals as sentinels for anthrax. When he found that a number of small animals were susceptible, he wondered why he had not heard of their use in the current outbreak, and he decided to ask. Why were animals not being used as sentinels in the current outbreak, Dr. Weniger asked of the speaker at the weekly meeting, Dr. Marc S. Traeger, a C.D.C. epidemic detective who is assigned to the Florida state health department. Dr. Traeger spoke about the investigation of anthrax in Florida that he had begun as soon as the first case was suspected in early October. As a veteran of West Nile fever investigations, Dr. Traeger said that health workers were using birds as sentinels for the viral infection, and that veterinarians monitor cattle and other animals for naturally occurring anthrax. Use of animal sentinels ''might be something that could be explored'' for anthrax, he said

About 3:30 a.m., after Dr. [Sherif R. Zaki] had finished explaining his findings, ''we walked away convinced,'' Dr. [Jeffrey P. Koplan] said. Ms. [Erin O'Connor] probably had anthrax. The C.D.C. doctors informed the New York City Health Department's top epidemiologist, Dr. Marcelle Layton. Dr. Koplan said the disease centers would remain on high alert for anthrax. The lull in reported cases ''has little meaning when a criminal act has been performed and someone is out there potentially with the will and the tools to do this again,'' Dr. Koplan said. At the headquarters of the Centers for Disease Control and Prevention in Atlanta, concrete barriers now restrict access, and armed private security guards inspect visitors' cars. (Photographs by Robin Nelson for The New York Times)(pg. F4); To deal with anthrax, Dr. Jeffrey P. Koplan rallied the federal disease centers' largest epidemiological force. (Associated Press)(pg. F1)

Assist pumps were first developed as a temporary measure to keep people with advanced heart failure or other severe cardiac problems alive while they waited for heart transplants. But when many patients, unable to get transplants, lived with the pumps for long periods -- some for four years -- doctors began looking to the device as a permanent therapy. Nevertheless, Dr. [Eric A. Rose] said that the device was not a cure for heart failure and that it involved a complication rate 2.35 times higher than that for drugs in the study. The complications included serious infections, bleeding and mechanical malfunctions like motor failure, kinking of the tubes and worn bearings. Dr. Rose said that the rate of complications was expected to fall with modifications to the device. The HeartMate is implanted in the abdomen and connected by two tubes to a ventricle, one of the heart's pumping chambers, and to the aorta, the body's main artery. One tube drains blood from the ventricle into the device, which pumps the blood to the aorta to nourish the body. Most assist pumps help the left ventricle, the heart's main pumping chamber

Until the intentional spread of anthrax in recent months, only 18 cases of inhalation anthrax had been reported since 1950, and 227 of the skin form from 1955 to the beginning of the intentional spread this fall. Additional anthrax cases may have gone undetected over the years, but the number would be small, infectious disease experts said in interviews. The boy's physician, Dr. William Borkowsky, a pediatric infectious disease specialist at New York University, said he made a point of studying anthrax when bioterrorism became a threat in recent years. Even so, Dr. Borkowsky said he would have diagnosed the infant's lesion as a spider bite if he had not known that anthrax was present in New York City. ''The syndrome this child had had never been described in anthrax'' but had been linked to spider bites, Dr. Borkowsky said. ''The skin lesions were compatible with anthrax, but the rest of the picture was incompatible because we reviewed all published cases of anthrax dating to the 1950's and never found the particular blood problem, microangiopathic hemolytic anemia, linked to anthrax in an adult or a child.''

DECATUR, Ga. -- About a month after anthrax spores were released from a letter in the office of Sen. Tom Daschle, D-S.D., researchers were able to stir up spores that remained there and disperse them into the air by simulating normal activity in the office, federal scientists reported. The scientists wore protective gear and moved carefully to avoid disturbing the office environment, placing 17 plates around Daschle's office to sample the air. The plates contained a blood agar gel that would allow anthrax spores, if any, to grow. The plates were left from 45 minutes to an hour in the sixth-floor room where the letter was opened on Oct. 15, the scientists said

Mr. and Mrs. [James Quinn] and Dr. [Louis E. Samuels] all spoke of his recovery as miraculous. Mr. Quinn said a major factor was his physical therapist, Kristi Olson, whom he jokingly called a tyrant. Mr. Quinn said that Dr. Samuels had kept him informed about the course of the five other AbioCor recipients and that he prayed for them. Tom Christerson is the only other living recipient to be publicly identified, at Jewish Hospital in Louisville. Two other unidentified recipients are at the University of California at Los Angeles and the Texas Heart Institute in Houston. Two other recipients have died, Mr. Tools and an unidentified man who died at the Texas institute from complications unrelated to the artificial heart. About nine years ago, Mr. Quinn developed idiopathic cardiomyopathy, a heart muscle disease with unknown origin. He did not have the coronary artery disease that caused Mr. Tools's heart to fail. To the extent comparisons are possible, Mr. Quinn appeared more robust in his first public appearance, about a month earlier in the recovery stage than Mr. Tools's

Pointing out that there had been at least 150 operations on the wrong site or the wrong patient since 1996, the Joint Commission on Accreditation of Healthcare Organizations issued its second..

Participants like Dr. Ross Brechner of the Maryland State Health Department said defining a big outbreak was difficult. One hundred cases could be a big one, ''but 1,000 would be a monster,'' Dr. Brechner said. The items include rugs, sets of china, jewelry, hundreds of envelopes, even wads of hundred-dollar bills, said two health officials, Dr. James Pearson of the Virginia Division of Consolidated Laboratory Services in Richmond and Elizabeth Franko, director of the Georgia Department of Health Laboratory. In the investigation, the C.D.C. collected blood from patients and people exposed to spores, to validate whether blood tests could help in detecting anthrax infection. For such testing, blood has to be collected at intervals of at least two weeks

Unless a startling finding emerges showing that Ottilie W. Lundgren, 94, of Oxford, Conn., and Kathy T. Nguyen, the 61-year-old hospital worker from the Bronx, somehow inhaled large amounts of spores with nary a trace left around their homes, the cases of these two women also puncture the notion that many spores are required to kill. Some government analysts took note of the postal threat, but the authorities said they never foresaw the widespread consequences of a real postal assault: the undermining of the operations and popularity of the postal system; the sealing of the offices of half of the Senate; and, most chillingly, the secondary spread of spores from letter to sorting machine to letter and -- in the end -- to the skin and lungs of unlikely and unintended victims. Dr. [Jeffrey P. Koplan], the director of the federal Centers for Disease Control and Prevention. (Associated Press); Ottilie W. Lundgren, 94, the widow from Oxford, Conn., who was killed by anthrax. (Reuters); Kathy T. Nguyen, the 61-year-old hospital worker from the Bronx who died of inhalation anthrax. (Associated Press)