Faculty Bibliography

Federal health officials issued their most comprehensive plan for containing an outbreak of smallpox in the event of a bioterrorist attack

In releasing their most comprehensive smallpox preparedness plan to date, officials at the federal Centers for Disease Control and Prevention said publicly for the first time that even one case of smallpox might result in a nationwide program of voluntary vaccinations. That is in part because even a single case could be a harbinger of a larger outbreak and in part because even one case would undoubtedly spark panic and a clamor for vaccine. The new document does not supplant the ''ring vaccination'' plan, Dr. [Julie Gerberding] said. But Dr. Bill Bicknell, a professor of international health at Boston University critical of that strategy, said the guide was undoubtedly influenced by recent studies showing that ring vaccination would not contain a large outbreak. He said studies had found that if 1,000 people were infected in a large city like New York and ring vaccination were used, within three months there would be 300,000 cases of smallpox and 100,000 deaths and the epidemic would not be contained. But mass vaccination, he said, would contain such an epidemic in 40 to 45 days, with 1,500 cases and 500 deaths. Federal officials began building a smallpox vaccine stockpile after last year's anthrax attacks. Mr. [Tommy G. Thompson], the health secretary, signed contracts with two companies to buy 209 million doses to add to the existing stockpile of vaccine, some of which dates to the 1950's. In the interim, studies have shown that the existing stockpile could be diluted

Because the vaccine is classified as ''investigational'' permission is required from any patient before receiving it. In the event mass vaccinations are offered, Dr. [Julie L. Gerberding] said, the C.D.C. has prepared a videotape in which she explains the risks and benefits of the vaccine with the hope that the tape will ease the permission process

Dr. [James E. Darnell] helped scientists understand that genes could work differently in bacteria from the way they work in animals and plants. He later discovered a simple path by which cells of mammals transmit signals from the environment to the nucleus. The process helps cells program their genes to respond to signals from their environment. For example, Dr. Darnell discovered in the 1980's that a liver cell could remain a liver cell only when it stayed in the liver. He found that without constant signals from their normal place in the organ, liver cells lost a crucial molecular component known as messenger RNA that helps give them their identity. Dr. Darnell also found the clearest example of how the surface of a cell signals genes in its nucleus. The signaling shows how cells directly respond to a type of hormone known as cytokines and to growth factors. The signaling is important in resisting infections and in inducing production of proteins known as STAT's, which play major roles in the origin and survival of cancer cells

Federal health officials said they were almost certain blood transfusions and organ transplants, as well as mosquito bites, can transmit the West..

[Willem J. Kolff]'s work on the artificial kidney began in 1938, when he developed a blood-filtering device to capture the poisonous waste products that the kidneys normally eliminate in urine. The first filter came from sausage casing

Doctors were urged to perform tests to distinguish Guillain-Barre Syndrome or strokes from West Nile because treatments for those two conditions have risks and would be useless for those with West Nile fever. No specific treatment exists for West Nile fever beyond supportive care like good nursing and mechanical respirators when needed. The West Nile virus is closely related to one that causes St. Louis encephalitis. The pattern of the current West Nile epidemic resembles an epidemic of St. Louis encephalitis with nearly 2,000 cases in 1975, Dr. [Lyle Petersen] said. Additional evidence that West Nile virus can be transmitted through transplants came yesterday from scientists at the New York state health department who tested organs and tissues from a patient who died of the infection. Dr. Dale L. Morse and Dr. Guthrie S. Birkhead of the health department said that their team had detected West Nile virus throughout the patient's body, including virtually every organ that can be transplanted. The patient's organs were not transplanted