Faculty Bibliography

A new statistical study has found that a vaccine known as BCG, for bacillus Calmette-Guerin, has been found to reduce the risk of full-fledged tuberculosis of the lung by 50% and death by 71%. BCG has been used only infrequently in the US, because federal health officials have considered it unreliable, but the new study seems certain to renew public health policy debates about the use of BCG. The study was conducted at the Harvard School of Public Health and was financed by the CDC

A vaccine to prevent tuberculosis that is used only infrequently in this country, largely because federal health officials consider it unreliable, is surprisingly effective, a new statistical study has discovered. It was found to reduce the risk of full-fledged tuberculosis of the lung by 50 percent and death by 71 percent. The vaccine known as BCG, for bacillus Calmette-Guerin, after the French scientists who began developing it in 1906, is reported to be the most widely used vaccine in the world. One major problem is that anyone who has had BCG vaccine will have a positive tuberculin skin test. The skin test, which is the mainstay of tuberculosis surveillance in the United States, would become meaningless as the use of BCG became widespread, and health officials would need to rely on chest X-rays and other methods to detect new infections

The new estimate could have critical health, political and economic ramifications. For planning purposes, health officials need to know where and how many new cases of H.I.V., the virus that causes AIDS, are occurring. Determining the national trend in H.I.V. infections and identifying geographical hot spots is crucial to making budgets, developing sound public health policy, evaluating the success of prevention programs and determining research needs and priorities. To health officials, the absolute number of H.I.V. infections is less important than whether the number of new H.I.V. infections is rising or falling. Ideally, statisticians want to know that number each year. But because such data are not collected nationally for H.I.V. and no national study has encompassed all high-risk groups, extrapolations must be made from small studies and surveys. The transmission of H.I.V. has by no means stopped in gay men. Studies in Chicago and Denver showed that 2.5 percent of gay men in their teen-age years and early 20's were becoming infected each year. Another study showed that despite an overall decline in new infection rates, many young gay men were becoming infected with H.I.V. in San Francisco and Berkeley, Calif.; the highest rates are in black gay men

After a decade of fierce debate and much research, the once heretical view that stomach ulcers are an infection caused by a bacterium, Helicobacter pylori, and are curable with antimicrobial drugs, has prevailed. And now leading researchers are turning to the public health implications of H. pylori, including a link to stomach cancer. So-called stomach ulcers appear in two places. Duodenal ulcers, which develop in the first part of the small intestine, are more common than gastric ulcers, which are in the stomach. Virtually all patients with duodenal ulcers have evidence of H. pylori infection, and about 80 percent of those with gastric ulcers harbor the organism. Few experts believe that H. pylori is the sole cause either of stomach ulcers or of cancer. The prevailing belief is that the two ailments result from a chain of events involving H. pylori at an early and crucial stage but that other factors are necessary for their development. The hope is that elimination of H. pylori from the body might provide the knockout blow to prevent stomach cancer

The CDC said on Feb 23, 1994 that a college student from Long Island NY died in Providence RI in January from the hantavirus, which caused a deadly outbreak of illness in the Southwest in the summer of 1993. It was the first hantavirus case in the Northeast

So-called stomach ulcers appear in two places. Duodenal ulcers, which develop in the first part of the small intestine, are more common than gastric ulcers, which are in the stomach. Virtually all patients with duodenal ulcers have evidence of H. pylori infection, and about 80 percent of those with gastric ulcers harbor the organism. The most convincing evidence for a causal association between ulcers and H. pylori infection comes from significant differences in rates of recurrence among ulcer patients who did and did not receive antimicrobials. Among ulcer patients in whom H. pylori is eliminated and who do not take a drug that can cause ulcers, the recurrence rate is less than 5 percent after two years, Dr. [David Y. Graham] said. For those who received standard therapy without antimicrobials -- drugs to block acid production -- and in whom H. pylori persisted, the recurrence rate is about 75 percent. Few experts believe that H. pylori is the sole cause either of stomach ulcers or of cancer. The prevailing belief is that the two ailments result from a chain of events involving H. pylori at an early and crucial stage but that other factors are necessary for their development. The hope is that elimination of H. pylori from the body might provide the knockout blow to prevent stomach cancer

'It is the first indication that mother-to-child transmission of HIV can be at least decreased, if not prevented,' he said, 'and it will provide a real impetus for identifying more HIV-infected women during pregnancies so that they could consider the benefit of AZT treatment to themselves and their children.' About 4 million women give birth in the United States each year, and the disease centers estimate that 6,000 to 7,000 of the women are HIV-infected. About 1,500 to 2,000 of their babies later become HIV-infected. On average, about 25 percent of pregnant women who are HIV-infected pass the virus to their babies. The researchers had confidence in the study because it found that 26 percent of newborns born to mothers who received a placebo during pregnancy were infected. But the infection rate was only 8 percent for those whose mothers received AZT, officials said

'It is the first indication that mother-to-child transmission of HIV can be at least decreased, if not prevented,' he said, 'and it will provide a real impetus for identifying more HIV-infected women during pregnancies so that they could consider the benefit of AZT treatment to themselves and their children,' he said. On average, about 25 percent of pregnant women who are HIV-infected pass along the virus to their babies. The researchers had confidence in the study because it found that 26 percent of newborns born to mothers who received a placebo pill during pregnancy were infected. But the infection rate was only 8 percent for those whose mothers received AZT, officials said. The new findings raise major practical and ethical questions. Until now, testing for HIV infection in the United States has been recommended for those who consider themselves at risk. But testing is not mandatory and there is no general recommendation to test all pregnant women. The American Academy of Pediatrics recommends testing of pregnant women in areas where the prevalence of HIV is high. But compliance among health officials varies

'It is the first indication that mother-to-child transmission of HIV can be at least decreased, if not prevented,' he said, 'and it will provide a real impetus for identifying more HIV-infected women during pregnancies so that they could consider the benefit of AZT treatment to themselves and their children,' he said. On average, about 25 percent of pregnant women who are HIV-infected pass along the virus to their babies. The study found that 26 percent of newborns born to mothers who received a placebo pill during pregnancy were infected. But the infection rate was only 8 percent for those whose mothers received AZT, officials said

''It is the first indication that mother-to-child transmission of HIV can be at least decreased, if not prevented,'' he said, ''and it will provide a real impetus for identifying more HIV-infected women during pregnancies so that they could consider the benefit of AZT treatment to themselves and their children.'' On average, about 25 percent of pregnant women who are HIV-infected pass along the virus to their babies. The researchers had confidence in the study because it found that 26 percent of newborns born to mothers who received a placebo bill during pregnancy were infected. But the infection rate was only 8 percent for those whose mothers received AZT, officials said. The new findings raise major practical and ethical questions. Until now, testing for HIV infection in the United States has been recommended for those who consider themselves at risk. But testing is not mandatory, and there is no general recommendation to test all pregnant women. The American Academy of Pediatrics recommends testing of pregnant women in areas where the prevalence of HIV is high. But compliance among health officials varies