Faculty Bibliography

Lassa fever is one of the hemorrhagic fever viruses, and its discovery was as striking as any in the history of virology. Yale halted research into it because infections acquired in the laboratory there killed one worker, in addition to making Dr. Casals deathly ill. Dr. Casals's team found the Lassa fever virus in the blood of three missionary nurses from the United States who had become ill in northern Nigeria. Two of the nurses died there. The third was Lily Pinneo, who had cared for her two nursing colleagues in Nigeria. She flew to Columbia-Presbyterian Hospital in Manhattan, where she recovered after a nine-week stay. Dr. Casals first felt ill in June 1969, shortly after he began working with the virus. But he said he did not think he had Lassa fever because his severe thigh-muscle aching was a symptom the nurses had escaped. A friend persuaded him to go to Columbia-Presbyterian. As Dr. Casals's illness became increasingly severe, his doctors grew to suspect the virus he was investigating

Hundreds of thousands of volunteers will begin going from house to house next week to give polio immunizations to 63 million children in 10 countries in the World Health Organization's latest effort to eliminate the disease. The program is to begin Monday in Nigeria and Niger, where polio is endemic

When the W.H.O. and the F.D.A. held their influenza vaccine meetings last year, experts knew that the Fujian strain had begun infecting people. But committee members said there was not enough information or time to include the Fujian strain in the vaccines given this season in the Northern Hemisphere. Influenza outbreaks tend to occur in the colder months of the year, which are reversed in the two hemispheres

When WHO and FDA held their influenza vaccine meetings last year, experts knew the Fujian strain had begun infecting people. But committee members said there was not enough information or time to include the Fujian strain in the vaccines given this season in the Northern Hemisphere, though it is included in the vaccines being readied for the Southern Hemisphere

Now that all states are reporting newly identified H.I.V. infections in addition to AIDS cases, the picture of this country's AIDS epidemic could change significantly. On Jan. 1, Georgia became the last state to start reporting H.I.V. infections. ''In New York City, we have a very old, continuously evolving epidemic and a brand new H.I.V. surveillance system'' that ''allows us to understand not only who is acquiring H.I.V. but who is transmitting it,'' said Dr. Lucia V. Torian, who directs the city's H.I.V. monitoring. A New York law required H.I.V. reporting to begin on June 1, 2000. At the 11th annual Conference on Retroviruses and Opportunistic Infections here, Dr. Denis Nash, formerly of the city health department and now with the New York Academy of Medicine, reported New York City data on new H.I.V. cases for 2001. About two-thirds were men and one-third women. Blacks and Hispanics were 5 and 2.5 times, respectively, as likely to become infected with H.I.V. as non-Hispanic whites in the city. The numbers have been stable since then

The research could have far-reaching implications. Experts knew that HIV could be resistant to nevirapine, but they were surprised by the findings that even a single dose could cause such a reaction. And because nevirapine is one of the three frontline therapies recommended by the World Health Organization to fight the spread of AIDS in developing countries, the results provide a sobering counterweight to its potency in reducing transmission of the virus to infants. A committee of experts said that AZT treatment for the mother from the 28th week of pregnancy, with a single dose of nevirapine at the onset of labor and a single dose of nevirapine plus one week of AZT for her newborn, was the most efficacious regimen for women who do not need chronic antiretroviral therapy. The Thai study found that women whose virus was drug resistant and later required long-term antiretroviral therapy were less likely to achieve maximal reduction of the amount of HIV in their blood if the drug therapy included nevirapine. But if treatment started more than six months after taking nevirapine, the amount of virus in the blood was lower

Her team investigated the outbreak using the new test, which is based on a technique known as P.C.R. (for polymerase chain reaction) and which can detect H.I.V., the AIDS virus, weeks earlier than the standard test. The initial weeks of H.I.V. infection is a period when the virus is easily transmitted because it is present in large amounts in the blood and semen. A Kaiser-Permanente team led by Dr. Michael Horberg analyzed the charts of 641 infected patients and 256 of 395 noninfected patients. A year after surgery, there were seven deaths among the infected patients and two among the noninfected. But the team attributed the deaths in infected patients to pre-existing conditions other than H.I.V. infection. The team undertook the study because doctors had a perception that suppressed immune function from H.I.V. would lead to a worse surgical outcome among infected patients. The team concluded that ''H.I.V. status should not by itself be a criterion for surgical consideration.''

The research could have far-reaching implications. Experts knew that H.I.V., the virus that causes AIDS, could be resistant to nevirapine, but they were surprised by the findings that even a single dose could cause such a reaction. And because nevirapine is one of the three front-line therapies recommended by the World Health Organization to fight the spread of AIDS in developing countries, the results provide a counterweight to its potency in reducing transmission of the virus to infants. Health officials have recommended since 1999 that an infected mother receive a single nevirapine pill during labor and that her newborn receive nevirapine once within the first three days of life. The therapy can reduce the risk of transmission of H.I.V. to 12 percent from 25 percent or more. The other new studies offset the good news. The resistance to nevirapine occurred in about 40 percent of infected women who took just one nevirapine pill during labor. Such resistance can persist for long periods of time, particularly when nevirapine is combined with other drugs for long-term treatment of H.I.V. infection and AIDS

The research could have far-reaching implications. Experts knew that HIV could be resistant to nevirapine, but they were surprised by the findings that even a single dose could cause such a reaction. And because nevirapine is one of the three front-line therapies recommended by the World Health Organization to fight the spread of AIDS in developing countries, the results provide a sobering counterweight to its potency in reducing transmission of the virus to infants. The other new studies offset the good news. The resistance to nevirapine occurred in about 40 percent of infected women who took just one nevirapine pill during labor. Such resistance can persist for long periods of time, particularly when nevirapine is combined with other drugs for long-term treatment of HIV infection and AIDS. Speaking at a news conference in San Francisco, Dr. Mary Glenn Fowler, a perinatal AIDS expert at the Centers for Disease Control and Prevention, said the Thai findings concerning AZT and nevirapine were dramatic. But she said that because the Thai study monitored the women and infants for only six months, and the potentially adverse resistance effects began to be seen only at six months, more studies are needed to determine how important resistance will be long term

The organizations and virologists said that no measure could be ruled out because of the unprecedented nature of the epidemic. It is caused by a strain of the A(H5N1) avian influenza virus that has mutated from one that caused smaller outbreaks in Hong Kong in 1997 and 2003. Experts in favor of large-scale vaccination contend that it will reduce the amount of virus that is spread among birds, and possibly to humans. But a crucial factor is that there is not enough vaccine right now to carry out such a measure, and that it would take months to produce enough to immunize birds in countries that decided to do so. The vaccines contain virus that has been grown in eggs and then killed. But because the avian influenza virus can kill chicken eggs, manufacturers have had to compromise by using a different and weaker strain, A(H5N2), and not A(H5N1), to make the vaccines, [Klaus Stoehr] said