Faculty Bibliography

There is general agreement among health officials that the latest ailment ''is not behaving like SARS because the illness is mild,'' Dr. [Perry Kendall] said, adding that it does not meet the case definition of SARS, or severe acute respiratory syndrome. Epidemiologists have found no link between any new case of the respiratory ailment and earlier cases of SARS, health officials said. Other theories include the possibility of a coronavirus -- SARS has been identified as a new member of the coronavirus family -- that previously went undetected because scientists had fewer laboratory tests to identify it and were not looking for new coronaviruses as hard as they have been in the wake of SARS. The tests of the nursing home specimens, conducted in British Columbia and at the National Microbiology Laboratory in Winnipeg, Manitoba, are extremely preliminary. Early tests of 3 percent of the genome of the coronavirus appear to indicate that it is identical to the SARS virus. But because information is lacking about the other 97 percent, the health officials stressed that much more laboratory work needed to be done to determine whether the coronavirus identified in Surrey is the SARS virus or one of a number of others from the same viral family that can cause respiratory illness

The tests of the Surrey nursing home specimens, conducted in British Columbia and at the Canadian national laboratories in Winnipeg, are extremely preliminary. Early tests of 3 percent of the genome of the coronavirus appear to indicate it is identical to the SARS virus. But because information is lacking about the other 97 percent, the health officials stressed that much more laboratory work needs to be done to determine whether the coronavirus identified in Surrey is SARS or one of a number of others from the same viral family that can cause respiratory illness. Other theories include the possibility of a coronavirus -- SARS has been identified as a new member of the coronavirus family -- that previously went undetected because scientists had fewer laboratory tests to identify it and were not looking for new coronaviruses as hard as they are now in the wake of SARS

The combination of cigarette smoking and tuberculosis appears to be far deadlier than previously believed, according to a large study conducted in India. The finding has important public health implications in developing countries where both are major public health problems. In India, smokers are four times as likely as nonsmokers to die of tuberculosis, the study found. The researchers estimated that nearly 200,000 people die there from tuberculosis every year because they have been smokers

Smoking and tuberculosis ''are two huge and two preventable epidemics,'' said Dr. Thomas R. Frieden, who investigated tuberculosis in India before he became New York City's current health commissioner. Dr. Frieden was not involved in the new study, which is being reported tomorrow in the journal Lancet. The journal described it as the first major study of how smoking causes death in India. ''India is well on its way to controlling tuberculosis, if the AIDS epidemic does not take off,'' Dr. Frieden said in an interview. Infection with the AIDS virus damages the immune system and makes people much more vulnerable to tuberculosis. There are about a billion women in Asia, where about 30 percent of men smoke, Dr. Frieden said. If cigarette companies could get the same smoking rate among women, ''that's another 300 million smokers and a lot of money,'' Dr. Frieden said

For example, it will be more difficult to eradicate polio than smallpox because smallpox produced a rash that was relatively easy to detect and distinguish from other skin diseases. But polio is just one of many conditions that can paralyze. So epidemiologists must check each case for polio virus as they try to rule out other causes. Also, only an estimated one in 200 people infected by polio develops paralysis; the overwhelming majority experience only diarrhea and other nonspecific gastrointestinal symptoms. In 15 years, the $3 billion program has reduced the incidence of paralytic polio by 99 percent. A few weeks later, [David L. Heymann] went to Africa to investigate a mysterious outbreak of hemorrhagic fever in Yambuku, Congo, then Zaire. The fever turned out to be a new disease, Ebola. There, he collected blood from local residents for laboratory tests to determine how many had been infected. The experience of investigating two new diseases in his first six months at the CDC hooked [Heyman] on a public health career. Unlike many other epidemiologists who become expert in one or two diseases, Heyman specialized in many. From 1977 through 1980, he investigated a number of diseases in Cameroon. Again, Ebola was one of them. Heymann's team found from blood collected from residents in Tandala, Congo, that a physician, who was thought to have acquired yellow fever from a cut while performing an autopsy on a nurse, in fact had survived Ebola. This and other studies showed that Ebola spread periodically without causing large outbreaks

For example, it will be more difficult to eradicate polio than smallpox because smallpox produced a rash that was relatively easy to detect and distinguish from other skin diseases. But polio is just one of many conditions that can paralyze. So epidemiologists must check each case for polio virus as they try to rule out other causes. Also, only an estimated one in 200 people infected by polio develops paralysis; the overwhelming majority experience only diarrhea and other nonspecific gastrointestinal symptoms. Suspecting that he could do more as a public health specialist than as a practicing physician, Dr. [David L. Heymann] went to the London School of Tropical Medicine and Hygiene. After graduating in 1974, he worked on the smallpox eradication program in India. Then to fill in time before joining the Epidemic Intelligence Service program at the Centers for Disease Control and Prevention in Atlanta, Dr. Heymann treated workers constructing the oil pipeline on the North Slope of Alaska. In 1988, Dr. Heymann moved to the agency's headquarters in Geneva to work on AIDS and other sexually transmitted diseases. In 1995, he went back to Africa to help contain an Ebola outbreak in Kikwit, Congo. The W.H.O. then put Dr. Heymann in charge of its emerging infections program. His team showed how the Internet and other modern means of communication can be combined with traditional epidemiological methods, like isolating infected and suspected cases, to help track the spread of infectious diseases and speed up their control

The epidemic poses a major threat to the future of South Africa's economy and security by primarily affecting young sexually active adults and incapacitating the country's traditional extended family system that cares for sick and orphaned relatives. So far, the epidemic has left 660,000 South African children as orphans. Yet, for years, as the AIDS virus has spread, President Thabo Mbeki and his aides have resisted programs to provide anti-HIV drugs, known as antiretrovirals, making him the target of intense criticism in South Africa and the world. South Africa said that because not every infected person needed anti-HIV drugs, its program would provide the drugs initially to people with more advanced cases of AIDS. The drugs can extend life for many people but are not a cure

The change in policy comes in the same week that South Africa held its first AIDS conference, and a month after President Bush pressed [Thabo Mbeki] to provide more effective treatments for AIDS sufferers during his visit to Africa. Bush has pledged to provide $15 billion over five years in fighting global AIDS, although it remains uncertain whether Congress and the Senate will appropriate that much