Faculty Bibliography

The top federal AIDS scientist, Dr. Anthony S. Fauci, raised the possibility Monday that the spread of drug-resistant tuberculosis might become as serious a public health threat as AIDS unless a major new research effort was begun against tuberculosis. Although the immediate tuberculosis threat is chiefly to people infected with the human immunodeficiency virus, which causes AIDS, participants at a Bethesda meeting expressed alarm that the spread of tuberculosis from such patients also threatened the health workers who care for them and ultimately healthy people who are not infected with HIV. Many health-care workers are infected with the virus

Several of the new outbreaks have been caused by deadly strains of bacteria that are resistant to most tuberculosis drugs. If further outbreaks occur, there will be more drug-resistant bacteria, and it will be only a matter of time before they supplant the susceptible strains as the most common form of tuberculosis. To bring the disease under control, the need is urgent for new antibiotics to combat drug-resistant tuberculosis as well as stronger public health programs. The goal of the latter is to treat all patients until they stop spreading the very contagious tuberculosis bacilli, which are dispersed in the air from coughing. But some experts wonder whether more extreme measures are needed, like reopening tuberculosis sanitariums, particularly for those who get drug-resistant tuberculosis. Experts are also asking for a review of legal measures to forcibly treat people who refuse to complete their antiobiotic therapy

On the eve of the National Basketball Association All-Star Game weekend, with rumors circulating about the physical condition of Magic Johnson, one of Johnson's doctors says that the player's condition has not deteriorated. 'He is mostly preoccupied with the issue of the Olympics, and we have agreed it's O.K. if it's not like all-out professional basketball -- we don't want him to go through that sort of thing,' [David Ho] said. Performed the Key Tests Johnson's condition has not changed since the diagnosis was made and key laboratory tests show no evidence that Johnson's immune system function is worsening, Ho said

[Burton Lee] said, 'Halcion's a non-issue in the president's health.' Halcion did not cause [Bush]'s collapse at the state dinner because 'he wouldn't have taken it within a week,' Lee said. [Marlin Fitzwater] has said that Bush last used Halcion to fight jet lag during his 12-day tour of Asia that ended Jan. 10. Bush also has told an interviewer that he took Halcion during the trip. Bush has taken Halcion on trips in the past, Fitzwater said in Washington. Both he and Lee said Bush has not taken Halcion on a daily basis

White House spokesperson Marlin Fitzwater stated that President Bush will avoid taking the sleeping pill Halcion because of the controversy over the side effects it may cause

An advisory committee to the FDA on Feb 4, 1992 recommended approval of the drug Proscar, which can be used to shrink enlarged prostate glands. The drug will be marketed by its manufacturer, Merck & Co of Rahway NJ

Officials at the CDC said on Jan 31, 1992 that although the US flu epidemic is fading, a new type of influenza virus called the Texas strain has appeared and could threaten the country in the next flu season

Several of the new outbreaks have been caused by deadly strains of bacteria that are resistant to most tuberculosis drugs. If further outbreaks occur, surely there will be more drug-resistant bacteria, and it will only be a matter of time before they supplant the susceptible strains as the most common form of tuberculosis. Tuberculosis can strike the affluent. For example, the diagnosis of tuberculosis was made too late to save the life of Eleanor Roosevelt, the former first lady who died of tuberculosis in 1962. Incomplete therapy fosters the development of drug-resistant strains, and when such patients returned to the community they spread drug-resistant tuberculosis. The resistant nature of such infections often went unrecognized because most laboratories did not test bacteria isolated from tuberculosis patients for susceptibility to drugs

Because tuberculosis is largely linked to poverty, many middle-class or wealthy people dismiss it as a disease they do not have to worry about. But tuberculosis can strike the affluent. For example, the diagnosis of tuberculosis was made too late to save the life of Eleanor Roosevelt, the former First Lady who died of tuberculosis in 1962. After all, treatment for tuberculosis was completely effective, although the cure was not quick. But many patients did not complete the full course of drug treatment because the workers who supervised such therapy were laid off. Incomplete therapy fosters the development of drug-resistant strains, and when such patients returned to the community they spread drug-resistant tuberculosis to others. The resistant nature of such infections often went unrecognized because most laboratories did not test bacteria isolated from tuberculosis patients for susceptibility to drugs. Since 1989, when Dr. [Louis W. Sullivan] announced the target to eliminate tuberculosis, drug-resistant tuberculosis has spread in at least 17 states. Dr. William L. Roper, director of the national Centers for Disease Control here, said doctors 'are surely less confident now than we were two or so years ago' that they will cure an individual patient of tuberculosis

Although federal health officials said last week that tuberculosis is out of control in the United States, they take some comfort in the fact that the disease is not particularly contagious. Certainly the spread of tuberculosis is not comparable to that of influenza, which can strike in explosive epidemics. Nor is it like outbreaks of measles and chicken pox, in which sick people can infect nearly everyone they meet who has not had the disease already. On average, people have a 50 percent chance of becoming infected if they spend eight hours a day for six months or 24 hours a day for two months working or living with someone who is sick with tuberculosis, said Dr. Lee B. Reichman