Faculty Bibliography

The presence and nucleotide sequences of the two mecA repressors, mecI and blaI, were assessed in 73 clinical Staphylococcus aureus isolates. Isolates with mecI mutations were grouped into unique clonal types based on their spa nucleotide repeat patterns. Forty-three of the 45 (96%) isolates with mutant mecI or with a deletion of mecI contained blaI, while blaI was present in only 21 of 28 (78%) isolates with wild-type mecI (P < 0.05). Among 22 additional isolates that did not contain blaI, all had wild-type mecI sequences. We conclude that oxacillin-resistant S. aureus must have at least one of the two functional mecA regulators

The director of the U.S. Centers for Disease Control and Prevention has warned that a mysterious respiratory disease, which has infected hundreds of people worldwide, could be spread very efficiently through close contact, and expressed deep concern that it might also be spread through the air or on contaminated objects. The warning from the agency director, Dr. Julie Gerberding, came Saturday as officials continued to monitor developments in Hong Kong, where the disease, known as SARS, for Severe Acute Respiratory Syndrome, may have sickened 78 people in one apartment complex. 'The potential for infecting large numbers of people is very great,' Gerberding said. 'We may be in the very early stages of a much larger' epidemic of a disease for which there is no specific treatment beyond standard supportive nursing and respiratory care, she said. 'This is new, we don't know a lot about it, and we have a lot of questions about the overall spread' of the disease and 'the possibility of airborne transmission,' she said in a conference call from Atlanta with reporters

'We are very concerned about the speed' with which SARS has spread in Hong Kong, [Julie L. Gerberding] said. Epidemiologic evidence exists that, for unknown reasons, some patients can transmit SARS to other people much more efficiently than other SARS patients can. Gerberding cited one patient in Hanoi, Vietnam, who spread SARS to 56 percent of the health workers with whom the patient came in contact. That incident occurred before hospital workers began using such barrier infection control measures as gloves, masks, gowns and goggles

Her warning came as the World Health Organization announced in Geneva that the doctor who first identified the fast-spreading disease has himself died of it. The doctor, Carlo Urbani, 46, identified the disease, known as SARS -- for severe acute respiratory syndrome -- in an American businessman admitted to a hospital in Hanoi, Vietnam, where Dr. Urbani was based. Epidemiologic evidence exists that, for unknown reasons, some patients can transmit SARS to other people much more efficiently than other SARS patients can. Dr. [Julie L. Gerberding] cited one patient in Hanoi who spread SARS to 56 percent of the health workers with whom the patient came in contact. That occurred before hospital workers began using measures like gloves, masks, gowns and goggles. The disease apparently first appeared in Guangdong Province, adjacent to Hong Kong, over the winter, and has infected about 800 people there. But it spread to Hong Kong through just one patient, a Chinese medical professor who had been treating patients in Guangdong and who went to the Metropole Hotel in Hong Kong on Feb. 21 and then fell ill

The warning from the disease agency director, Dr. Julie L. Gerberding, came as officials continued to monitor developments in Hong Kong where the disease, known as SARS, for severe acute respiratory syndrome, may have sickened 78 people in one apartment complex. 'We are very concerned about the speed' with which SARS has spread in Hong Kong, Gerberding said. Epidemiologic evidence exists that, for unknown reasons, some patients can transmit SARS to other people much more efficiently than other SARS patients can. Gerberding cited one patient in Hanoi, who spread SARS to 56 percent of the health workers with whom the patient came in contact

'This is new. We don't know a lot about it, and we have a lot of questions about the overall spread' of SARS and 'the possibility of airborne transmission,' she said. 'We are very concerned about the speed' with which SARS has spread in Hong Kong. There's epidemiologic evidence that, for unknown reasons, some patients can transmit SARS to other people much more efficiently than other SARS patients can. [Julie Gerberding] cited one patient in Hanoi, Vietnam, who spread SARS to 56 percent of the health workers with whom the patient came in contact

In Canada, health officials asked that the thousands of people in Toronto who have been in the Scarborough Grace Hospital since March 16 isolate themselves at home for 10 days from the time of their visit. Two people at the hospital have died from SARS. Premier Ernie Eves of Ontario declared SARS a provincial emergency yesterday. In Hong Kong, top officials yesterday ordered more than 1,000 family members of SARS patients to stay home except for visits to government clinics to check for the disease. Those who violate the quarantine face fines of up to $640 and up to six months in jail. In addition, the government closed all primary and secondary schools for nine days as the number of suspected cases climbed by 51, to 367. Singapore decided on Monday to close all schools and restrict SARS patients to their homes. Based on the spread and course of the illness, health officials have repeatedly said that it takes close contact to transmit the SARS agent, presumably a virus, from an ill person to other people. Individuals most likely to transmit SARS are those who are quite sick and have a fever and cough. Most cases have involved health-care workers who have cared for patients, their family members and friends

The new figures are being released just days after a World Health Organization team arrived in China to help investigate this country's epidemic of the mystery pneumonia, which goes by the name SARS, for severe acute respiratory syndrome. A clearer picture of the course of SARS emerged on Wednesday after 80 doctors who have treated cases in 13 countries held a teleconference moderated by Dr. [Salter]. In a second group, from 10 to 20 percent of patients develop increasing difficulty in breathing. Such patients usually required breathing assistance with a mechanical ventilator, and many have had to stay on ventilators for a long time. Most SARS deaths have involved patients in this group

U.S. health officials say that the mysterious respiratory illness that has sickened hundreds of people around the world might be caused by a different virus from the one first suspected. In recent days the World Health Organization said its team of 11 laboratories worldwide had suggested that the cause of the illness, known as SARS, for severe acute respiratory syndrome, might be a previously unknown member of the paramyxoviridae family of viruses. But Monday, the U.S. Centers for Disease Control and Prevention, a member of the World Health Organization team, announced it had found very strong evidence that 'a previously unrecognized virus from the coronavirus family is the leading hypothesis' for the cause of SARS. Among other illnesses, coronaviruses cause the common cold. 'This virus could be, if not the entire cause of SARS, at least contributing to SARS,' Dr. Julie Gerberding, director of the centers, said at a news conference. But she cautioned that it was 'very premature to assign a cause.' Dr. Klaus Stoehr, a virologist who heads the investigation of SARS for the World Health Organization, said the cause could be a paramyxoviridae virus alone, a coronavirus alone or a co-infection of both. 'There is no clear- cut evidence to rule out either virus, so we cannot drop any hypothesis now,' Stoehr said in an interview. 'The investigation has become relatively complex.' Identifying a specific cause is critical because it would allow health officials to better control outbreaks and possibly find a specific therapy

The seven had clearly defined risk factors for heart disease or had heart problems. But heart problems are not known to put people at greater risk of adverse reactions to smallpox vaccine, said Dr. Julie L. Gerberding, the director of the Centers for Disease Control and Prevention. Tommy G. Thompson, the secretary of health and human services, agreed in a meeting yesterday afternoon with the disease agency's recommendation to defer smallpox vaccinations for people with heart disease, Dr. Gerberding said. The decision was made even though no definitive link between the vaccination and adverse reactions had been made and the cases had not been thoroughly studied. Dr. Gerberding said that in the event of a smallpox outbreak from bioterrorism, health officials would abandon the precaution because in such an event the risk of the disease would outweigh what at this point is only a speculative link between the vaccine and heart problems