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 Casals deathly ill. Casals' team found the Lassa fever virus in the blood of three American missionary nurses 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. 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 the severe pain in his thigh muscles was a symptom the nurses had escaped. A friend persuaded him to go to Columbia- Presbyterian. As Casals' illness became increasingly severe, his doctors began to suspect the virus he was investigating

Nigeria is believed to have also exported the infections to the seven other previously polio-free African countries: Benin, Burkina Faso, Cameroon, the Central African Republic, Ghana, Togo and Chad. The World Health Organization says the exported cases and continued opposition to polio vaccination by religious and political leaders in the northern states of Nigeria are jeopardizing its efforts to eradicate polio by the end of this year. Dr. [David L. Heymann] said the vaccine being used in Nigeria and elsewhere in Africa was the same one that reduced the incidence of paralytic polio to less than 758 cases in 2003. Nigeria accounted for 347 of those cases. Nigeria sent the vaccine to South Africa for testing. Although the tests found no elements of hormones or infectious agents other than the Sabin polio virus used in the oral vaccine, Dr. Heymann said, they did not satisfy the critics. So a second set of tests is being performed in India.

The most thought-provoking stories, for me, were from the students whose issues were either invisible or rarely talked about in public discourse: the student who is a recovering alcoholic; the student in remission from obsessive-compulsive disorder; the student who is taking 6 instead of 4 years to complete medical training because of frequent flares of sickle-cell disease; the obese student who tries to retain her smile when she discovers that the school doesn't make scrubs or laboratory coats large enough to fit her; the single parent who knows that if she accepts a scholarship, she will jeopardise her chances of getting government benefits for her young child; the poverty-line student who is too proud, or too ashamed, to check off "financially disadvantaged" on the application forms, and has to take care not to get grease on his hands as he changes into his interview suit in the bathroom of his uncle's auto repair shop; the Muslim woman who knows that one item of clothing-her laboratory coat-will make others look at her with respect, while another-her headscarf-will cause many to look at her with suspicion; the devout Christian student who is ashamed because she does not defend her religion when her superiors make derogatory comments; and the Vietnamese refugee, the Mexican "wetback", the grandchild of four Holocaust survivors, and the Native American raised in downtown Los Angeles who all struggle with identity and legacy in a world rife with stereotypes about who doctors (and who Americans) should be

BACKGROUND: New York City residents were exposed to a variety of inhaled substances after the collapse of the World Trade Center. Exposure to these substances might lead to an increase in asthma severity, with residential distance from Ground Zero predictive of the degree of change. OBJECTIVE: We sought to assess the effect of the World Trade Center collapse on local pediatric asthmatic patients. METHODS: We retrospectively reviewed the charts of 205 pediatric patients with established asthma from a clinic in lower Manhattan's Chinatown. Clinical data were obtained for the year before and the year after September 11, 2001. Measurements included numbers of visits, asthma medication prescriptions, oral corticosteroid prescriptions, weekly doses of rescue inhaler, and peak expiratory flow rates. Residential zip codes were used to compare the asthma severity of patients living within and beyond a 5-mile radius of Ground Zero. RESULTS: After September 11, 2001, these children had more asthma-related clinic visits (P = .002) and received more prescriptions for asthma medications (P = .018). No significant differences in oral steroid or rescue inhaler use were noted. Those living within 5 miles had more clinic visits after September 11, 2001 (P = .013); the increase in clinic visits for patients living more than 5 miles from Ground Zero was not significant. Mean percent predicted peak expiratory flow rates decreased solely for those patients living within 5 miles of Ground Zero during the 3 months after September 11, 2001. CONCLUSIONS: Asthma severity worsened after September 11, 2001, in pediatric asthmatic patients living near Ground Zero. Residential proximity to Ground Zero was predictive of the degree of decrease in asthma health

The N and W-Beijing families of Mycobacterium tuberculosis are phylogenetically closely related. The ability of the W-Beijing family to rapidly cause widespread disease is well described; however, few outbreaks involving the N family have been reported outside the New York City, N.Y., area. During 2002 to 2003, Seattle, Wash., experienced a rapidly expanding tuberculosis outbreak involving 38 persons in a 23-month period. The outbreak strain, SBRI9, exhibited the genotypic properties of the N family. Its IS6110 restriction fragment length polymorphism pattern was identical or nearly identical to those of two N family strains that were responsible for clusters of tuberculosis cases, including a large nosocomial outbreak, in New York City and New Jersey from 1989 to 1990. It was also identical to strains involved in late 1990s tuberculosis cases in Michigan, Maryland, and Arkansas. Further monitoring of the N family may show that it shares with the W-Beijing family the propensity to spread rapidly, suggesting that this characteristic evolved prior to the divergence of the two genetic lineages

BACKGROUND AND AIMS: 6-mercaptopurine has proven to be effective in the treatment and maintenance of remission of ulcerative colitis (UC). The optimal duration of treatment with 6-MP is unknown. The intention of this study was to determine the best duration of treatment with 6-MP in terms of maintenance efficacy once remission has been achieved. METHODS: We reviewed the records from the inflammatory bowel disease (IBD) center at Lenox Hill Hospital and one large IBD practice in New York City of 334 patients treated with 6-MP for UC. These patients were followed from 4 months to 28.7 yr. Sixty-one patients were treated with 6-MP for at least 6 months and had at least a 3-month disease-free interval off steroids while on the medication. These patients were divided into two groups: Group 1 continued 6-MP and group 2 discontinued the drug at various times for reasons other than relapse. Time to relapse was calculated for both groups. RESULTS: A Kaplan-Meier survival analysis was employed and differences between the two groups were analyzed using the log-rank test. The median time to relapse in group 2 was 24 wk and in group 1 was 58 wk (p < 0.05). There were no significant differences between the two groups in age, gender, extent of disease, use of concomitant 5-ASA products, dose of 6-MP during remission, duration of UC, and duration of treatment with 6-MP before remission was achieved. CONCLUSION: Discontinuation of treatment with 6-MP while UC is in remission leads to a higher relapse rate than maintenance on 6-MP. Therefore, we favor the indefinite treatment with 6-MP in most patients

The young brides are apparently acquiring H.I.V., the AIDS virus, from their husbands, who tend to be many years older and were infected before marriage, the officials said. Dr. Catherine Hankins, chief scientific adviser to United Nations AIDS program, said ''it's the first time we have ever seen'' differences in H.I.V. infection rates between married women and sexually active single women ages 15 to 19. She commented from the agency's headquarters in Geneva on remarks made at the meeting by Dr. [Paul DeLay] and Carol Bellamy, the director of Unicef. ''The striking finding here is that among 15-to-19-year-old girls who are sexually active in these two settings, the fact of being married carries significantly higher risk -- in part because of the increased age differential between spouses and in part because condom use in marriage has not been promoted,'' she said. ''Common H.I.V./AIDS protection messages are often inappropriate for married adolescents who seem to have been a forgotten population.''

Sexually transmitted diseases and certain other common infections affect women disproportionately, compared with men, and can be dangerous, particularly in pregnancy, said the official, Dr. Julie L. Gerberding. Dr. Gerberding is director of the Centers for Disease Control and Prevention here. One is that certain diseases can cause more serious illness and lead to more severe complications among pregnant women. Another is that women are at least four times more vulnerable to infection from H.I.V. and other sexually transmitted diseases. New H.I.V. infections are also increasing among women in the United States. In 2001 in New York City, 35 percent of new H.I.V. diagnoses were in women, compared with 28 percent before 2001

''Low influenza vaccination rates among health care workers pose a serious health threat to the patients in their care, including infants and children, the elderly and chronically ill,'' said Dr. William Schaffner, a board member of the foundation, a nonprofit group in Bethesda, Md., dedicated to the prevention and treatment of infectious diseases. Many members of the advisory panel expressed strong support for the foundation's plea. The panel, the Advisory Committee on Immunization Practices, has recommended influenza vaccinations for health workers since 1986 and so took no action on Wednesday. The Department of Health and Human Services appoints the 15-member panel to advise the centers, which are based here, on influenza immunizations and others. Dr. Kathleen M. Neuzil of the Veterans Affairs Puget Sound Health Care System and the University of Washington, urged state health departments and the centers to formally track influenza vaccination rates among health workers. Dr. Neuzil attended the meeting as a representative of the American College of Physicians, which supports the foundation's program