Faculty Bibliography

BACKGROUND: There is no consensus on the diagnosis and therapy of oral allergy syndrome (OAS; also known as pollen-food allergy syndrome), a disorder caused by IgE antibody-mediated reactions to homologous proteins in pollens and fruits and vegetables. OBJECTIVE: We sought to determine how practicing allergists define and treat OAS. METHODS: A questionnaire was mailed to 226 randomly selected US allergists from the American Academy of Allergy, Asthma and Immunology directory. RESULTS: One hundred twenty-two (54%) returned surveys were analyzed. Median estimates of the prevalence of OAS among the patients with pollen allergy were 5% among children and 8% among adults. Twenty percent of allergists reported that some patients progressed to systemic symptoms. Fifty-three percent of allergists recommended complete avoidance of causal foods to all patients, whereas 9% did not advocate any restrictions. Thirty percent never prescribed epinephrine for OAS, 3% always did, and the remainder did so on the basis of symptoms. When presented with clinical cases, 20% diagnosed systemic reactions to peach as OAS, 13% believed peanut could cause OAS, and 25% did not prescribe epinephrine for peanut allergy manifested by oral symptoms. CONCLUSION: Allergists' estimates of the prevalence of OAS in patients with pollen allergy (5%-8%) are lower than the prevalence reported (approximately 50%) in the published studies of these patients, perhaps reflecting a low index of suspicion, underdiagnosis, or both. The wide range of responses regarding diagnosis and management indicates the need for a better definition for the disorder and standard therapeutic guidelines. Discrepancies might be related to the term OAS, and therefore use of the more specific term "pollen-food allergy syndrome" is suggested.

Asylum seekers arriving in the United States are often imprisoned for months or years while their asylum claims are processed. Recently, Physicians for Human Rights and the Bellevue/New York University Program for Survivors of Torture released the findings of the first systematic study examining the health of detained asylum seekers. The study found that the mental health of asylum seekers interviewed was extremely poor, including high levels of symptoms for anxiety, depression, and posttraumatic stress disorder, which worsened the longer individuals were in detention. The study also raises concerns about the manner in which asylum seekers are treated upon arrival in the United States and then while in detention. These findings support assertions that detention has a harmful effect on the health and well-being of asylum seekers. Policies regarding the long-term detention of asylum seekers should be reconsidered

In their vigil for a possible return of SARS, health officials have focused mainly on finding where the virus hides in nature. But the case of severe acute respiratory syndrome in a 27-year-old doctoral student in Singapore has shown an equally important risk -- escape of the virus from a laboratory. 'Inappropriate laboratory standards and a cross-contamination of West Nile virus samples with SARS coronavirus in the laboratory led to the infection of the doctoral student,' the committee reported. No additional spread occurred, preserving the disease's eradication. But the scientist in charge of the laboratory committed suicide. Now, many laboratories around the world have stored thousands of SARS specimens in freezers, ready to be thawed as needed. The WHO has cautioned China and other countries that accidents may occur in laboratories where there is little experience with dangerous infectious agents

''Inappropriate laboratory standards and a cross-contamination of West Nile virus samples with SARS coronavirus in the laboratory led to the infection of the doctoral student,'' the committee reported. After the epidemic ended, the laboratory worked on the West Nile virus and SARS coronavirus at the same time. The committee said that the laboratory did not pause to review its procedures and that its record-keeping system was poor. As part of the committee's investigation, it asked Singapore scientists to thaw and test a stored vial that was supposed to contain West Nile virus only. SARS virus was also detected

The researcher worked in a laboratory that Singapore had created to study the West Nile virus and other diseases before SARS became an epidemic earlier this year. The laboratory grew the SARS virus to provide materials for developing diagnostic tests. Because the Singapore government and the health organization's officials are deeply concerned about the possibility of SARS accidentally escaping from a laboratory, Singapore asked the health organization, a Geneva-based U.N. agency, to send an expert committee to investigate the circumstances of the researcher's case

The first report card on the United Nation's 2-year-old commitment to defeat AIDS gives the world's countries generally low marks in their efforts to overcome ignorance about the disease and provide access to prevention and treatment measures, UN officials said. At the General Assembly's special session on AIDS in June 2001, UN members agreed that defeating AIDS would take commitment, resources and action. The $4.7 billion is five times the amount spent in 1996 but less than half the $10 billion required for an effective response in 2005 and one-third of what will be needed by 2007, [Peter Piot] said. In part because of inadequate funding, many countries will not meet basic goals like rapidly expanding AIDS prevention and care that were expected of them by 2005. One goal is to ensure that by 2005 at least 80 percent of pregnant women have access to information, counseling and treatment to prevent transmission of the AIDS virus. But such services remain virtually nonexistent in the countries that are worst affected by AIDS, according to the report card that Piot's agency issued here Monday

The first report card on the United Nations' two-year-old commitment to defeat AIDS gives the world's countries generally low marks in their efforts to overcome ignorance about the disease and provide access to prevention and treatment measures, UN officials said. At the General Assembly's special session on AIDS in June 2001, UN members agreed that defeating AIDS would take commitment, resources and action

The researcher worked in a laboratory that Singapore had created to study the West Nile virus and other diseases before SARS became epidemic earlier this year. The laboratory grew the SARS virus to provide materials for developing diagnostic tests. Because the Singapore government and the health organization's officials are deeply concerned about the possibility of SARS accidentally escaping from a laboratory, Singapore asked the health organization, a United Nations agency based in Geneva, to send an expert committee to investigate the circumstances of the researcher's case

The researcher worked in a laboratory that Singapore had created to study the West Nile virus and other diseases before SARS became epidemic earlier this year. The laboratory grew the SARS virus to provide materials for developing diagnostic tests