Faculty Bibliography

An analysis of a blood sample preserved since 1959 from the oldest documented case of infection with the AIDS virus called H.I.V.-1 shows that the first such infections probably occurred in people in the late 1940's or early 1950's, about a decade earlier than many estimates, scientists said today. The researchers compared that sample with others to build a family tree to trace changes in the fast-mutating AIDS virus. The family tree, or phylogenetic analysis, is in the shape of a starburst, with branches radiating from the center, and the 1959 virus is close to the center. The scientists used calculations to estimate the date when the virus first developed. The 1959 sample came from a Bantu man who lived in Leopoldville, Belgian Congo (now Kinshasa in the Democratic Republic of Congo). In 1986, scientists used what were then the latest laboratory techniques to show that he had been infected by H.I.V.-1. But only now could scientists, using the latest powerful tools of molecular biology, identify key fragments of the virus in the last few drops of the blood sample in a quest for the origins of the AIDS virus

AIDS deaths in New York City plummeted by 48 percent last year, accelerating earlier gains attributed to improved drug therapies, health officials said at a scientific meeting here today. They said the declines crossed sex and racial lines, suggesting that the new therapies were reaching all segments of the AIDS population. Theoretically, the decline in AIDS deaths could have resulted from prevention efforts or some unknown factor, the health experts meeting here said. But the likeliest explanation is expanded use of combinations of newer and older drugs that began to be introduced in recent years, New York City and Federal health officials said. ''This is a new era'' in AIDS, Dr. Kevin DeCock, an AIDS official from the Centers for Disease Control and Prevention in Atlanta, said at a news conference. ''We can't think that the end of the epidemic is in sight, but it certainly is the beginning of a new period.'' Dr. DeCock heads the unit at the centers that monitors AIDS cases in this country. ''The challenge now is to improve prevention,'' he told the 3,400 participants in the meeting here

FOR Dr. Gro Harlem Brundtland, the newly designated head of the World Health Organization and former Prime Minister of Norway, the path from medicine to international politics was natural. After all, she was born into the Norwegian power elite, the daughter of a politically oriented physician and long-time Cabinet minister. ''Why should you leave politics, which is the most important thing happening in a democratic society, to somebody who does not understand science?'' Dr. Brundtland, 58, said last week, shortly after being nominated to head the W.H.O. Members of the United Nations subagency are expected to ratify her nomination at their annual meeting in May, making her the first woman to head the Geneva-based organization. In three terms as Norwegian Prime Minister -- in 1981, from 1986 to 1989 and from 1990 to 1996 -- Dr. Brundtland increased the number of women in the Cabinet and in other key government positions. Dr. Brundtland said she intends to do the same at the W.H.O., where about 30 percent of staff members are women, though the proportion among the top echelon is much lower

OBJECTIVE: To investigate suspected pseudo-outbreaks of Mycobacterium tuberculosis (MTB) during August 1994 and July 1995 among patients who did not have clinical findings consistent with tuberculosis. DESIGN: Retrospective and prospective surveys of all clinical and laboratory data using standard epidemiological tools and DNA fingerprinting. SETTING: A university-affiliated community hospital. PATIENTS: Those with positive MTB cultures during periods when we noted that the number of MTB positive cultures greatly outnumbered the usual monthly average (retrospective analysis, 1994) and patients with positive MTB cultures without clinical findings consistent with tuberculosis (prospective survey, 1995). RESULTS: Epidemiological and molecular studies revealed specimen cross-contamination in the laboratory due to a faulty exhaust hood. Improvement in laboratory ventilation and change of the implicated hood prevented further specimen contamination. CONCLUSIONS: The identification of positive MTB cultures from patients without clinical evidence of tuberculosis should be a signal to suspect laboratory contamination and implement control measures. These should include a thorough epidemiological investigation, DNA fingerprint analysis, and an environmental inspection

Back when John Glenn joined the astronaut corps, as the United States prepared for its first urgent forays into space, he and his fellow pilots took a notoriously dim view of the men in white, the doctors who could ground them for medical cause. But now that NASA is giving Glenn one last chance to show the 'right stuff' in space, he is enlisting the medical profession on his side: One rationale cited by the agency for Glenn's participation in the flight is the opportunity to carry out medical research on what will be the oldest human body to orbit the Earth so far. In pleading with NASA to allow him to fly aboard the space shuttle, Sen. Glenn, D-Ohio, tapped into some medical experts' interest in the parallels between the biological effects of aging and space travel

But now that NASA is giving Mr. Glenn one last chance to show the ''right stuff'' in space, he is enlisting the medical profession on his side: one rationale cited by the agency for Mr. Glenn's participation in the flight is the opportunity to carry out medical research on what will be the oldest human body to orbit the Earth so far. But whether information collected from a sole geriatric volunteer will be sufficient to be meaningful is controversial. In metabolism experiments for the shuttle flight, Mr. Glenn will swallow capsules containing one type of amino acid and receive intravenous injections of another. Then low-level X-ray studies will help detect any changes in lean body mass. Because amino acids are the building blocks of protein, the aim will be to relate any changes in hormonal levels with loss of protein and muscle atrophy in Mr. Glenn and, eventually, eight other crew members. For a sleep experiment, Mr. Glenn will swallow melatonin or placebo pills before retiring on four nights. He will also swallow a capsule containing a small thermometer to record core body temperature because that is a good indicator of biological rhythms. Devices attached to Mr. Glenn's scalp, chest and wrist during monitoring periods will record brain wave activity, breathing patterns and movements during sleep. Mr. Glenn will give samples of his blood and wastes as part of the research

As Thomas Rowe tested samples of the deadly ''bird flu'' strain of influenza virus in a high-security Federal laboratory here this week, a plastic shield protected his face, the air he breathed was filtered as it came through a hose from a battery-powered respirator, a blue gown shielded his body and booties covered his shoes. Mr. Rowe, a research biologist, wore two pairs of latex gloves as he handled samples containing infectious components of the ''bird flu'' virus, known as influenza A(H5N1), under a safety hood in the laboratory at the Centers for Disease Control and Prevention here. The hood above the laboratory bench is designed to reduce the risk that workers like Mr. Rowe will become accidentally infected, and the laboratory building is under negative pressure so that if a door is opened inadvertently, air will rush in, not out, to prevent the escape of dangerous microbes. The laboratory work is vital to the swift public health response to the threat of ''bird flu.'' It is needed to understand the virus at its most basic level, to develop tests to help doctors and health officials detect cases and to make a vaccine in case it is needed to help prevent large outbreaks of illness caused by A(H5N1)

Yet as late as this month, neither the U.S. government nor WHO had approved final plans to counter a pandemic, even as they helped the government of Hong Kong deal with a worrisome outbreak of 'bird flu.' 'It is astounding and atrocious that we haven't had more resources made available to us to get this thing done,' said Peter Patriarca, a Food and Drug Administration official who was the principal author of a recently completed U.S. draft plan on how to battle a flu pandemic. The hope is that the avian strain, known as A(H5N1), will peter out. But one fear is that the strain will adapt to allow easy human-to-human transmission. Another is that it will mix with one of the several human influenza strains now circulating to create yet another strain, one with the potential for producing a pandemic -- the term used when the disease strikes large numbers of people in a number of countries in a short time

Yet, surprisingly, neither the United States Government nor W.H.O. has approved final plans to counter a pandemic, even as they help the Government of Hong Kong deal with a worrisome outbreak of ''bird flu.'' That strain of influenza virus is the first to jump from birds to humans without going through other animals. The Government created a panel in 1993 to come up with a plan to deal with an influenza pandemic, and the latest draft, written last week, is being sent to Donna E. Shalala, the Secretary of Health and Human Services. Approval is expected quickly now that events in Hong Kong have heightened awareness, Government officials said. But they acknowledged that the Hong Kong outbreak had pointed up gaps in the draft, making further revisions likely. United States and W.H.O. officials interviewed expressed confidence in the thoroughness of their draft plans for a pandemic. But W.H.O. refused to release a copy of its draft. The American disease-control agency initially denied repeated requests for a copy of the nation's draft plan, but Dr. Peter A. Patriarca, an official of the Food and Drug Administration who is the principal author of the American drafts, released it over the weekend