Faculty Bibliography

New York City's investigation of an outbreak of an intestinal ailment caused by a microbe has created an extraordinary conflict between the Health Dept and a leading scientist, Rosemary Soave, over reporting cases of the ailment, cyclospora. Health Commissioner Margaret A. Hamburg subpoenaed records from Soave, who said that she had declined an initial request to turn over the records, citing patient confidentiality and the fact that some patients had been referred to her by other doctors

'I tell them it's Ontario. They're afraid. They think I lie to them,' he said. 'Some of them say, 'If I get sick, I'll come back to you.' I say 'Okay.' '

We examined the effect of diet on gallstone incidence and the composition of biliary phosphatidylcholines in methyltestosterone-treated female hamsters. These hamsters were fed a nutritionally adequate purified lithogenic diet containing 2% corn oil, 4% butterfat, 0.3% cholesterol, and 0.05% methyltestosterone, resulting in a cholesterol gallstone incidence of 86%. This incidence was lowered when mono- and polyunsaturated fats or fatty acids were added to the diet: 2.5% oleic acid resulted in total prevention of cholesterol cholelithiasis, 2.5% linoleic acid, and 4% safflower oil (78% linoleic acid content) reduced gallstone incidence to 26 and 8%, respectively. An additional 4% butterfat (29% oleic acid content) produced gallstones in 50% of the animals. At the end of the 6-wk feeding period, the bile of all hamsters was supersaturated with cholesterol. The major biliary phosphatidylcholine species in all groups were (sn-1-sn-2): 16:0-18:2, 16:0-18:1, 18:0-18:2, 16:0-20:4, and 18:2-18:2. The safflower oil- and linoleic acid-fed hamsters exhibited an enrichment of 16:0-18:2 (16-18%); added butterfat or oleic acid increased the proportion of 16:0-18:1 (9 and 25%, respectively). We conclude that the phosphatidylcholine molecular species in female hamster bile can be altered by dietary fats/fatty acids and that mono- and polyunsaturated fatty acids play a role in suppressing the induced cholelithiasis.

Approximately half a million women migrate to the United States annually; more than two-thirds of them of childbearing age. Early entry into the health care system may be the most effective way to ensure positive health at lower costs and to enable ever-shrinking health care resources to be used most effectively. Immigrant women, however, face economic, legal, linguistic, and cultural barriers to health care. Successful programs have been developed to systematically address immigrant women's health care issues, targeting preventive health services and education to diverse communities

The microbe, cyclospora, is a parasite that infects the intestine and can cause diarrhea, weight loss and fatigue.Tracking cyclospora's penetration of the food supply is proving hard. Earlier patients had said they recalled eating strawberries, but in the more-recent outbreaks, raspberries have emerged as prime suspects. Officials are trying to rush a technique into use called polymerase chain reaction, or PCR, that could detect a single microbe of cyclospora because of speculation that so few microbes are required to infect a person that they escape detection by current techniques

Federal officials are developing a crash program to test food and other items for cyclospora, an exotic microbe that is known or suspected to have made more than 1,000 people sick in 11 states. Investigators are also shifting the focus of their suspicions from strawberries to raspberries as the source of contamination. The microbe is a parasite that infects the intestine and can cause intense diarrhea, weight loss and fatigue

The Food and Drug Administration has asked six laboratories - four of its own, one at the CDC in Atlanta and another at the California health department - to use the PCR test to try to detect cyclospora on fruit. The tests are being done on leftovers from implicated meals served in homes and restaurants, and from random samples collected from stores, distributors and growers. Investigation of the outbreaks has been further complicated by the medical novelty of cyclospora. Most doctors lack experience in diagnosing and treating cyclospora, if they have ever heard of it. Many laboratories do not test for cyclospora, and many that do are not adequately trained in how to detect it. Another difficulty in the investigation is the nature of cyclospora. Food histories are the backbone of the epidemiologic investigations. But with cyclospora, the incubation period is about a week, longer than for many other food-borne infections

The microbe, known as cyclospora, is a parasite that infects the intestine and can cause intense diarrhea, weight loss and fatigue. It has caused three previous outbreaks of disease in the United States, but the ones that started this spring are by far the largest. Despite warnings about such diseases, the current cyclospora outbreak has caught health officials by surprise. They say that parasites are rarely the cause of large food-borne outbreaks and that this is the first major one in the United States in recent years. The U.S. food supply is considered very safe. But Stephen Ostroff of the Centres for Disease Control and Prevention and other U.S. officials said that the cyclospora outbreak ``highlights the potential vulnerability'' of the food supply when a crack appears in the safety walls that protect it

Summary: Health officials are hurriedly developing a test to detect cyclospora, which has sickened more than 1,000 in 11 states The microbe, known as cyclospora, is a parasite that infects the intestine and can cause intense diarrhea, weight loss and fatigue. Cyclospora has caused three previous outbreaks of disease in the United States, but the ones that started this spring are by far the largest. The current cyclospora outbreak has caught health officials by surprise. They say parasites rarely cause large food-borne outbreaks and that this is the first major national one in recent years. In 1993, an outbreak of cryptosporidiosis in the Milwaukee water supply sickened 400,000 people. in 1993