Faculty Bibliography

Doctors regard transplants performed between identical twins very differently from those between people who do not have identical genes. Transplanting an organ between identical twins can be likened to taking tissue from one area of a person's body and putting it in another area of the body. The transplant recipient does not need antirejection drugs. They include Ms. [Edith Helm] and another of Dr. [Joseph E. Murray]'s patients; a patient whose surgery was performed with Dr. Murray's assistance at the [Thomas E. Starzl] Oregon Health & Sciences University in Portland in 1959; and a patient of Dr. Starzl's who received a kidney at the Veterans Administration Hospital in Denver in 1962. Dr. Murray recalled that when Ms. Helm was having her first child, she was in the same hospital in Boston where Dr. Murray's wife, Bobby, was delivering her fifth child, Tom. Since then, Dr. Murray has often stopped to visit Ms. Helm on the way to see Tom in Denton, Tex

Immediate health threats include wounds from stepping on nails and broken glass; dehydration and heat stroke from exposure in hot, muggy weather; the possibility of electrocution from downed wires; and diarrhea and respiratory diseases caused by various bacteria and viruses that can spread rapidly because of poor sanitation and a lack of clean water. Doctors Without Borders had to delay until Wednesday a shipment of 32 tons of relief materials to Sumatra from Ostende, Belgium, because of the lack of an available airplane. The cargo includes generators, water bladders and tanks; plastic sheeting; mosquito nets; chlorination kits; a hospital tent; and various medical supplies

The human tally in Indonesia jumped after officials said that nearly 28,000 more bodies had been uncovered in Aceh Province, on the island of Sumatra, near the epicenter of Sunday's enormous undersea earthquake. The discovery brought the death count close to 80,000 in this country alone. As the relief effort struggled to lift off, the death toll continued to rise along with fears of looting and disease. Sri Lanka reported more than 27,000 dead, India more than 10,000. Prime Minister Thaksin Shinawatra of Thailand said he feared the toll there could reach 7,000. In the areas washed by the tsunami, all supplies are short, but the lines for gasoline yesterday in Banda Aceh, Indonesia, stretched through town. (Photo by Choo Youn-Kong/Agence France-Presse--Getty Images)(pg. A1); On Phi-Phi island, off Thailand, relief workers searched a market yesterday for bodies, wrapping them in plastic to take them for burial. (Photo by Kin Cheung/Reuters)(pg. A10)

UNICEF already had large storage tanks for water in India and has moved some of them to affected areas in the south and east, said a UNICEF spokesman, Alfred Ironside. The tanks can be set up in communities and then refilled by tanker trucks, he said. Families are then given clean jerry cans to carry their own supplies. 'In the early days, a family may have to walk a mile or two inland to where water systems were not affected by flood waters,' Ironside said. 'The jerry cans are good for that.' But he added that the system was in place mainly in India and in Sri Lanka, not in Indonesia, the scene of much of the worst devastation. 'Around Ampara is one of the worst-affected areas,' [Robert Schofield] said in a telephone interview from the group's headquarters in Lausanne, Switzerland. He added that 177,000 people, displaced by destruction along the coast, had fled about 12 miles inland and set up camps around Ampara, because it is the largest town in the vicinity. Medair reports that 120 camps have cropped up; the World Health Organization estimates the number at 500

UNICEF already had large storage tanks for water in India and has moved some of them to affected areas in the south and east, said a UNICEF spokesman, Alfred Ironside. 'In the early days, a family may have to walk a mile or two inland to where water systems were not affected by flood waters,' Ironside said. 'The jerry cans are good for that.' But he added that the system was in place mainly in India and in Sri Lanka, not in Indonesia, the scene of much of the worst devastation

Another hazard to drinking water is contamination of wells by salt water from the tsunamis. Martin Dawes, a regional spokesman for Unicef in Colombo, estimated that 1,000 drinking-water wells in Sri Lanka's hard-hit eastern region had been contaminated. 'At the moment,' he said, 'the water people don't have the right kind of pumps to rescue the wells.' Dawes said Unicef had also bought about 75 million liters, or 20 million gallons, of drinking water, enough for 100,000 people, and was expecting it to be delivered to the affected areas Thursday

Unicef already had large storage tanks for water in India and has moved some of them to affected areas in the south and east, said a Unicef spokesman, Alfred Ironside. The tanks can be set up in communities and then refilled by tanker trucks, he said. Families are then given clean jerry cans to carry their own supplies. ''Around Ampara is one of the worst-affected areas,'' Mr. [Robert Schofield] said in a telephone interview from the group's headquarters in Lausanne, Switzerland. He added that 177,000 people, displaced by destruction along the coast, had fled about 12 miles inland and set up camps around Ampara, because it is the largest town in the vicinity. Medair reports that 120 camps have cropped up; the World Health Organization estimates the number at 500. ''We're bringing in pumps to clean out the wells,'' Mr. Ironside said. He said that the government in Sri Lanka had requested several dozen pumps and that Unicef was shipping the dozen or so it already had on hand

While no epidemics have been confirmed in the vast coastal areas devastated by the tsunamis on Sunday, the officials said they were most worried about diarrheal diseases -- cholera, typhoid fever and shigellosis -- as well as liver diseases like hepatitis A and E. Those diseases are caused by bacteria or viruses in contaminated drinking water or food, in sewage and among people who lack clean water to wash their hands. Health organizations like the W.H.O. and Unicef recommend that each person be given about five gallons of clean water a day. Dr. David Nabarro, the director of crisis operations for the W.H.O., said in a telephone interview from its headquarters in Geneva that water shortages had already occurred in the Maldives and Sri Lanka, and that tanker trucks would be needed to provide clean water. Among the diarrheal diseases, cholera, typhoid and shigellosis are caused by bacteria. In cholera, the bacterium produces a toxin that causes severe fluid loss and can kill quickly, and the key to treating it is to replace fluids. Typhoid can also be fatal and requires antibiotic treatment. Shigellosis causes severe dysentery but usually goes away in about a week

Until 1997, scientists had not believed it was even possible for an avian influenza virus to pass directly from birds to people without first combining with a mammalian influenza virus. Pigs can harbour avian and mammalian influenza viruses while showing no ill effects, and have been blamed for periodically allowing new avian influenza viruses into human populations that have little, if any, immunity to them. Many mammalian influenza viruses have already mastered the tricky secret of passing easily from person to person. These viruses kill about 50,000 people a year in North America. The ideal strategy for the A(H5N1) virus would be to infect a person already carrying a human influenza virus and then swap genetic material with it. Because pigs can readily carry human and avian influenza viruses, they could also be the mixing vessels for a new virus. Thai and Vietnamese officials have said they are testing pigs extensively. The virus has been detected in at least two pigs in southeastern China. Dr. Klaus Stoehr, the WHO's top influenza expert, said that while recombination of the avian influenza virus would probably be a slow process, a reassortment of genes by human and avian influenza viruses could happen, 'very rapidly, practically within days.'

Logistical problems abound as international organizations attempt to fly in material for temporary health centers to supplement the hospitals that are likely to be inundated with people. Doctors Without Borders said it had to delay until Wednesday a shipment of 32 tons of relief materials to Sumatra from Ostende, Belgium, because of the lack of an available airplane. The cargo includes generators, water bladders and tanks, plastic sheeting, mosquito nets, chlorination kits, a hospital tent and medical supplies