Faculty Bibliography

Nigeria has exported polio cases to at least six countries in West Africa in recent months, the health agency has said, jeopardizing efforts to have polio join smallpox as the only diseases to be eliminated from the human population. ''Nigeria is unequivocably committed politically to the eradication of polio,'' Professor [Eyitayo Lambo] said. ''We want to bury totally polio in Nigeria by December 2004.'' Dr. David L. Heymann, the epidemiologist in charge of the agency's program to eradicate polio, said that the ministers were given the option of the end of 2004 or 2005 as their goal for stopping transmission of the polio virus, and that they chose 2004

Officials had warned that there was a mismatch between the current vaccine and the Fujian strain of influenza virus that was causing most illness this season. But they said the vaccine should still offer some protection to many people. At meetings last February and March where experts made educated guesses about what strains to use in preparing this season's vaccine, the panel members knew about the new Fujian strain. But it was too late to include it in the vaccine manufactured for the Northern Hemisphere. The vaccine being prepared for the Southern Hemisphere is formulated to protect against the Fujian strain. The effectiveness rates of influenza vaccine vary in part according to the age and health status of the individual. Influenza vaccine prevents illness in about 80 percent of children and young adults. The vaccine is less effective in preventing symptoms among those 65 and older, but prevents major complications like pneumonia in about 70 percent of those who receive it in the older population

Laboratory tests have confirmed that Nigeria was the source of the polio virus that led to two new cases of the crippling disease in Benin and Cameroon in West Africa, the World Health Organization said

Nigeria has exported polio to at least six West African countries in recent months, [David Heymann] said. His team is awaiting molecular tests to determine whether the viruses isolated from the Benin and Cameroon cases came from Nigeria or one of the seven neighboring countries that have reported cases. They are: Benin, Burkina Faso, Cameroon, Chad, Ghana, Niger and Togo. Cameroon and Benin are now conducting such campaigns in an effort to prevent the imported cases from spreading further. But the immunization campaigns are costly and put an added burden on countries that had previously eradicated polio because they take money from other important health programs, Heymann said. In a second move, the WHO has invited the health ministers from affected countries to discuss polio eradication at the agency's headquarters in Geneva on Thursday. Nigeria's national health minister has made a commitment to attend the meeting, as has a representative of the state of Kano, where the opposition to polio vaccination programs is centered, Heymann said

A year ago, the transmission of SARS, or severe acute respiratory syndrome, was occurring in Guangdong Province in China. But provincial and Chinese officials did not report SARS to the World Health Organization, as they were supposed to do. Initially, officials kept secret the cases of the new disease that were first detected in November 2002. Then officials lied until the disease spread from Guangdong and China to other countries in Asia and Canada in February 2003. Now, in an effort to persuade the world that they are cooperating and taking steps to control the disease, Chinese officials have slaughtered hundreds of civets and other animals in which the SARS coronavirus has been found. Also, they are reporting even suspect SARS cases to the W.H.O., something that is not required, said Dick Thompson, a spokesman for the United Nations agency. Chinese officials have not disclosed the number of people tested for possible SARS. If they have tested hundreds of people and only the four have shown some evidence of SARS, then SARS might represent less of a health problem

Nine children and an adult have died in Hanoi since October from a rare strain of avian influenza that usually spreads from birds to people, the World Health Organization said. Three other children have survived infection from the strain, known as Influenza A(H5N1)

Second judgment call: Should I leave work that evening without getting the results of the X-ray? Given that Mr. [Miah] was already clinically improving, it was hard to imagine that there would be anything on the X-ray that would change my management. And if there was something terrible there, he wouldn't be feeling better after one day of erythromycin. Right? I sent Mr. Miah for another chest X-ray, then had him wait while I walked the X-ray film over to a radiologist. Only the bone radiologist was available, so I gave her the chest X-ray. She was concerned that the fluid had now partially solidified and might be holding a pocket of pus. That would require admission to the hospital for a chest tube to be inserted. She told me that I'd need a CT scan to figure this out. Given the vagaries of a city hospital, it could take up to two weeks to obtain an outpatient CT, but if I admitted him, he would get the scan tomorrow. All of medicine is probability. If 80% of people with ordinary pneumonia get better on erythromycin and Mr. Miah turns out not to be one of them, does it mean that my decision was wrong? If I call Mr. Miah and he feels fine, would my decision, then, have been the right thing?

Nigeria has exported polio to at least six West African countries in recent months, [David Heymann] said. His team is awaiting molecular tests to determine whether the viruses isolated from the Benin and Cameroon cases came from Nigeria or one of the seven neighboring countries that have reported cases. They are: Benin, Burkina Faso, Cameroon, Chad, Ghana, Niger and Togo. Cameroon and Benin are now conducting such campaigns in an effort to prevent the imported cases from spreading further. But the immunization campaigns are costly and put an added burden on countries that had previously eradicated polio because they take money from other important health programs, Heymann said. In a second move, the WHO has invited the health ministers from affected countries to discuss polio eradication at the agency's headquarters in Geneva on Thursday. Nigeria's national health minister has made a commitment to attend the meeting, as has a representative of the state of Kano, where the opposition to polio vaccination programs is centered, Heymann said

Siegel comments on the new prescription drug coverage. The new plan creates a system whereby patients will have to pay top price for drugs they must buy themselves before the coverage kicks again. The new Medicare bill will bring the drug companies easy access to a group that can't afford to underwrite their fancy corporate schemes

''It is a setback, and the situation is really very concerning,'' Dr. David L. Heymann, the epidemiologist in charge of the W.H.O. polio eradication program, said in telephone interviews. ''But we cannot let the effort fail. We have no choice -- we have to stop transmission this year.'' Nigeria has exported polio to at least six West African countries in recent months, Dr. Heymann said. His team is awaiting molecular tests to determine whether the viruses isolated from the Benin and Cameroon cases came from Nigeria or one of the seven neighboring countries that have reported cases. They are: Benin, Burkina Faso, Cameroon, Chad, Ghana, Niger and Togo. Cameroon and Benin are now conducting such campaigns in an effort to prevent the imported cases from spreading further. But the immunization campaigns are costly and put an added burden on countries that had previously eradicated polio because they take money from other important health programs, Dr. Heymann said