Faculty Bibliography

The bacteria can cause the same variety of problems in animals and humans, including skin infections, abscesses, joint infections and death. The infections can be difficult to treat, raising concern about the potential for animals to serve as sources of infection among their human contacts. The questions that epidemiologists at the centers are adding to continuing studies are aimed at determining the source of such infections. Are some people acquiring the antibiotic-resistant staphylococcal infections from pets? Or are pets being infected from exposure to people? If so, how often are each occurring? Staphylococci are commonly found on human skin and in the nasal passages, but much less so on animal skin, Dr. [Shelley C. Rankin] said. Methicillin-resistant staphylococcal infections have been found among horses, and outbreaks have occurred in equine hospitals. But no cases of infection among horses have been linked to people, Dr. [Nina Morano] said in an interview

This scenario reads like something from our near future. Experts predict that the bird flu virus might hit our shores within a year. In fact, it's a news flash from three decades ago. The events of the so-called swine flu in the USA seem hauntingly familiar to those of us who are focused on the current bird flu, and they can serve as a useful guide on what to do now and -- perhaps as important -- what not to do. The rush to make vaccines for a flu virus to which we have no immunity is not a new concept. This is what happened during the swine flu fiasco of 1976, when the fear of another killer outbreak provoked a national political response and a rushed vaccination program. More than 40 million people received the swine flu vaccine that year against a new pig virus that ultimately never took hold. It was later determined that the swine flu wasn't as virulent or as deadly as originally thought. But more than 1,000 cases of Guillain-Barre syndrome, a life-threatening ascending paralysis, occurred in those who received the vaccine, which had been rushed into production. The public relations nightmare and lawsuits against the government helped to drive many drug companies away from making flu vaccine at all. (Of 27 companies that manufactured flu vaccines at the time, only three still do.)

Recently, some critics have objected to the organization's practice of keeping some of the virus's genetic information in a secret database. One critic, Ilaria Capua, an Italian veterinary scientist who works on avian influenza, has challenged the system by refusing to send her own data to the password-protected archive. Instead, she released the information publicly and urged her colleagues to do the same. More timely release of information about avian influenza and other infectious agents ''will become increasingly routine,'' largely as a legacy of the SARS outbreaks in 2003, said Dr. Keiji Fukuda, another expert on influenza at the agency. In the fall of 2002, China lied about the existence of the earliest cases of SARS. Within a few months, SARS spread to Canada and a number of other countries

[Robert Webster]'s statement is the latest Hitchcockian pronouncement about H5N1 bird flu, a virus that is deadly in birds. But humans are different. We are protected by a species barrier, and serological surveys conducted in 1997 in Hong Kong and since have detected antibodies in thousands of humans who never got sick, showing that bird flu isn't as deadly to the few who come in contact with it as has been reported. If H5N1 takes hold in pigs and exchanges genetic material with another flu virus, the result is likely to be far less deadly. The swine flu fiasco of 1976 is an example of the damage that can be done from fear of a mutated virus that can theoretically affect us. More than 1,000 cases of paralysis occurred from a rushed vaccine given to more than 40 million people in response to a pandemic that never came

While there might have been a large, prospective, double-blind, placebo-controlled study of healthy, uninsured, mildly diabetic, previously febrile but currently afebrile, Pakistani men in the diagnosis and treatment of presumptive community-acquired pneumonia, I wasn't aware of it, and for sure didn't have the time to go hunting on Medline with eight other patients waiting to see me. Yes, there has been enough written about diabetes to sink a galleon, but there is no invariant law that will predict exactly what will transpire in my patient with his unique constellation of glucose control, pulmonary pathology, drug absorption, cultural expectations, financial constraints, and personality quirks

BACKGROUND: The Direct Repeat locus of the Mycobacterium tuberculosis complex (MTC) is a member of the CRISPR (Clustered regularly interspaced short palindromic repeats) sequences family. Spoligotyping is the widely used PCR-based reverse-hybridization blotting technique that assays the genetic diversity of this locus and is useful both for clinical laboratory, molecular epidemiology, evolutionary and population genetics. It is easy, robust, cheap, and produces highly diverse portable numerical results, as the result of the combination of (1) Unique Events Polymorphism (UEP) (2) Insertion-Sequence-mediated genetic recombination. Genetic convergence, although rare, was also previously demonstrated. Three previous international spoligotype databases had partly revealed the global and local geographical structures of MTC bacilli populations, however, there was a need for the release of a new, more representative and extended, international spoligotyping database. RESULTS: The fourth international spoligotyping database, SpolDB4, describes 1939 shared-types (STs) representative of a total of 39,295 strains from 122 countries, which are tentatively classified into 62 clades/lineages using a mixed expert-based and bioinformatical approach. The SpolDB4 update adds 26 new potentially phylogeographically-specific MTC genotype families. It provides a clearer picture of the current MTC genomes diversity as well as on the relationships between the genetic attributes investigated (spoligotypes) and the infra-species classification and evolutionary history of the species. Indeed, an independent Naive-Bayes mixture-model analysis has validated main of the previous supervised SpolDB3 classification results, confirming the usefulness of both supervised and unsupervised models as an approach to understand MTC population structure. Updated results on the epidemiological status of spoligotypes, as well as genetic prevalence maps on six main lineages are also shown. Our results suggests the existence of fine geographical genetic clines within MTC populations, that could mirror the passed and present Homo sapiens sapiens demographical and mycobacterial co-evolutionary history whose structure could be further reconstructed and modelled, thereby providing a large-scale conceptual framework of the global TB Epidemiologic Network. CONCLUSION: Our results broaden the knowledge of the global phylogeography of the MTC complex. SpolDB4 should be a very useful tool to better define the identity of a given MTC clinical isolate, and to better analyze the links between its current spreading and previous evolutionary history. The building and mining of extended MTC polymorphic genetic databases is in progress

Mr. [George E. Pataki], 60, said he had taken a number of telephone calls in his hospital room from well-wishers. His spokesman, David Catalfamo, said that Mr. Pataki had spoken with former President Bill Clinton and Gov. Ernie Fletcher of Kentucky. Mr. Catalfamo said that one of the reasons Mr. Pataki appeared at the news conference was to reassure his mother, Margaret, who was concerned about news reports about his medical condition. On Tuesday, Mr. Pataki's doctors revealed that his ruptured appendix left him more seriously ill than his staff and doctors had previously acknowledged. For the first week that Mr. Pataki was at NewYork-Presbyterian/Columbia hospital, his doctors and staff gave little information about his medical condition, not fully explaining the need for his second operation or revealing the peritonitis and abscesses. Yesterday, Mr. Catalfamo defended the staff's handling of the information about Mr. Pataki's illness, saying, ''We are doing our best to provide the public with as much information as we understand.''

They used the word ''peritonitis'' -- the name of a potentially fatal inflammation of the abdominal lining -- only after being pressed repeatedly by reporters. They also described abscesses but declined to use that word, and declined to say how high a fever Mr. [George E. Pataki] had. And although they said that his bowel function was impaired but improving, they would not elaborate despite repeated questioning. Dr. Dennis L. Fowler said yesterday that the adhesions were new and probably caused by the ruptured appendix and the first operation. Dr. [Spencer E. Amory] said that after examining Mr. Pataki and reviewing his records, ''I thought the governor received excellent care at Hudson Valley.'' When asked whether Mr. Pataki had peritonitis, Dr. Amory said there was ''a spread of infection within the abdomen.'' He was asked again, and gave a similar answer. When asked a third time, he said the condition he described ''is defined as peritonitis.''