Faculty Bibliography

A 'bird flu' strain of influenza virus has caused only 20 confirmed or suspected cases of human illness in Hong Kong, all since May, and has not been found elsewhere. Yet Hong Kong health officials are so worried about the virus that last Monday they began slaughtering all 1.2 million chickens in the territory. And virologists around the world have been burning the midnight oil for several weeks, studying the strain and attempting to make a vaccine for it

Yet, surprisingly, neither the United States Government nor W.H.O. has approved final plans to counter a pandemic, even as they help the Government of Hong Kong deal with a worrisome outbreak of ''bird flu.'' That strain of influenza virus is the first to jump from birds to humans without going through other animals. The Government created a panel in 1993 to come up with a plan to deal with an influenza pandemic, and the latest draft, written last week, is being sent to Donna E. Shalala, the Secretary of Health and Human Services. Approval is expected quickly now that events in Hong Kong have heightened awareness, Government officials said. But they acknowledged that the Hong Kong outbreak had pointed up gaps in the draft, making further revisions likely. United States and W.H.O. officials interviewed expressed confidence in the thoroughness of their draft plans for a pandemic. But W.H.O. refused to release a copy of its draft. The American disease-control agency initially denied repeated requests for a copy of the nation's draft plan, but Dr. Peter A. Patriarca, an official of the Food and Drug Administration who is the principal author of the American drafts, released it over the weekend

Yet as late as this month, neither the U.S. government nor WHO had approved final plans to counter a pandemic, even as they helped the government of Hong Kong deal with a worrisome outbreak of 'bird flu.' 'It is astounding and atrocious that we haven't had more resources made available to us to get this thing done,' said Peter Patriarca, a Food and Drug Administration official who was the principal author of a recently completed U.S. draft plan on how to battle a flu pandemic. The hope is that the avian strain, known as A(H5N1), will peter out. But one fear is that the strain will adapt to allow easy human-to-human transmission. Another is that it will mix with one of the several human influenza strains now circulating to create yet another strain, one with the potential for producing a pandemic -- the term used when the disease strikes large numbers of people in a number of countries in a short time

As Thomas Rowe tested samples of the deadly ''bird flu'' strain of influenza virus in a high-security Federal laboratory here this week, a plastic shield protected his face, the air he breathed was filtered as it came through a hose from a battery-powered respirator, a blue gown shielded his body and booties covered his shoes. Mr. Rowe, a research biologist, wore two pairs of latex gloves as he handled samples containing infectious components of the ''bird flu'' virus, known as influenza A(H5N1), under a safety hood in the laboratory at the Centers for Disease Control and Prevention here. The hood above the laboratory bench is designed to reduce the risk that workers like Mr. Rowe will become accidentally infected, and the laboratory building is under negative pressure so that if a door is opened inadvertently, air will rush in, not out, to prevent the escape of dangerous microbes. The laboratory work is vital to the swift public health response to the threat of ''bird flu.'' It is needed to understand the virus at its most basic level, to develop tests to help doctors and health officials detect cases and to make a vaccine in case it is needed to help prevent large outbreaks of illness caused by A(H5N1)

But now that NASA is giving Mr. Glenn one last chance to show the ''right stuff'' in space, he is enlisting the medical profession on his side: one rationale cited by the agency for Mr. Glenn's participation in the flight is the opportunity to carry out medical research on what will be the oldest human body to orbit the Earth so far. But whether information collected from a sole geriatric volunteer will be sufficient to be meaningful is controversial. In metabolism experiments for the shuttle flight, Mr. Glenn will swallow capsules containing one type of amino acid and receive intravenous injections of another. Then low-level X-ray studies will help detect any changes in lean body mass. Because amino acids are the building blocks of protein, the aim will be to relate any changes in hormonal levels with loss of protein and muscle atrophy in Mr. Glenn and, eventually, eight other crew members. For a sleep experiment, Mr. Glenn will swallow melatonin or placebo pills before retiring on four nights. He will also swallow a capsule containing a small thermometer to record core body temperature because that is a good indicator of biological rhythms. Devices attached to Mr. Glenn's scalp, chest and wrist during monitoring periods will record brain wave activity, breathing patterns and movements during sleep. Mr. Glenn will give samples of his blood and wastes as part of the research

Back when John Glenn joined the astronaut corps, as the United States prepared for its first urgent forays into space, he and his fellow pilots took a notoriously dim view of the men in white, the doctors who could ground them for medical cause. But now that NASA is giving Glenn one last chance to show the 'right stuff' in space, he is enlisting the medical profession on his side: One rationale cited by the agency for Glenn's participation in the flight is the opportunity to carry out medical research on what will be the oldest human body to orbit the Earth so far. In pleading with NASA to allow him to fly aboard the space shuttle, Sen. Glenn, D-Ohio, tapped into some medical experts' interest in the parallels between the biological effects of aging and space travel

FOR Dr. Gro Harlem Brundtland, the newly designated head of the World Health Organization and former Prime Minister of Norway, the path from medicine to international politics was natural. After all, she was born into the Norwegian power elite, the daughter of a politically oriented physician and long-time Cabinet minister. ''Why should you leave politics, which is the most important thing happening in a democratic society, to somebody who does not understand science?'' Dr. Brundtland, 58, said last week, shortly after being nominated to head the W.H.O. Members of the United Nations subagency are expected to ratify her nomination at their annual meeting in May, making her the first woman to head the Geneva-based organization. In three terms as Norwegian Prime Minister -- in 1981, from 1986 to 1989 and from 1990 to 1996 -- Dr. Brundtland increased the number of women in the Cabinet and in other key government positions. Dr. Brundtland said she intends to do the same at the W.H.O., where about 30 percent of staff members are women, though the proportion among the top echelon is much lower

AIDS deaths in New York City plummeted by 48 percent last year, accelerating earlier gains attributed to improved drug therapies, health officials said at a scientific meeting here today. They said the declines crossed sex and racial lines, suggesting that the new therapies were reaching all segments of the AIDS population. Theoretically, the decline in AIDS deaths could have resulted from prevention efforts or some unknown factor, the health experts meeting here said. But the likeliest explanation is expanded use of combinations of newer and older drugs that began to be introduced in recent years, New York City and Federal health officials said. ''This is a new era'' in AIDS, Dr. Kevin DeCock, an AIDS official from the Centers for Disease Control and Prevention in Atlanta, said at a news conference. ''We can't think that the end of the epidemic is in sight, but it certainly is the beginning of a new period.'' Dr. DeCock heads the unit at the centers that monitors AIDS cases in this country. ''The challenge now is to improve prevention,'' he told the 3,400 participants in the meeting here

The breast cancer drug tamoxifen significantly reduces the rates of recurrence and death from the disease among a surprisingly wide range of women but is being prescribed to far too few patients, researchers reported Thursday in the world's largest analysis of any cancer treatment. Contrary to what many doctors had thought, tamoxifen benefits breast cancer patients of all ages, not just those who have gone through menopause, and is effective whether the cancer was confined to the breast or had spread to lymph nodes in the arm pit, the study found. Tamoxifen also is effective whether the cancer was removed surgically in a lumpectomy or mastectomy, treated with radiation or chemotherapy drugs. Tamoxifen also halves the incidence of new cancers in the breast opposite the site of the first cancer

The first full-scale trials of an experimental drug that attacks a genetic defect in breast cancer cells show significant promise for women with advanced cancer, scientists reported Sunday. The drug, Herceptin, heightened the benefits of chemotherapy by shrinking tumors and slowing progression of a particular type of breast cancer, one that is responsible for about 30 percent of the 180,000 new cases of the disease in the United States each year, the scientists said at the annual meeting of the American Society of Clinical Oncology in Los Angeles. Participants at the meeting greeted the reports with cautious optimism, and leaders said they are planning to test the drug, which was developed by Genentech of south San Francisco, among patients with less advanced forms of the breast cancer and among the 20 percent of ovarian cancer cases involving the same genetic defect