Faculty Bibliography

A 'bird flu' strain of influenza virus has caused only 20 confirmed or suspected cases of human illness in Hong Kong, all since May, and has not been found elsewhere. Yet Hong Kong health officials are so worried about the virus that last Monday they began slaughtering all 1.2 million chickens in the territory. And virologists around the world have been burning the midnight oil for several weeks, studying the strain and attempting to make a vaccine for it

A 'bird flu' strain has caused only 20 confirmed or suspected cases of human illness in Hong Kong, all since May, and has not been found elsewhere. Yet Hong Kong health officials are so worried about the virus that they have slaughtered 1.3 million chickens in the territory. And virologists around the world have been burning the midnight oil for several weeks, studying the strain and attempting to make a vaccine for it. The main reason is the strain's novelty for humans. It has been seen only in poultry before, and the strain infecting humans is the same one that has killed thousands of chickens in Hong Kong. Scientists believe that the virus is transmitted when someone touches an infected person, not through the air - the usual way influenza spreads. But scientists are puzzled about exactly how the virus is transmitted. Whether the destruction of Hong Kong chickens will stop the transmission of the virus is an unanswered question. But as long as A(H5N1) infections continue to occur, no one can know where the Hong Kong outbreak will lead. For now, [Keiji Fukuda] said, 'there is clearly a great deal of concern that this virus could take hold and lead to a pandemic.'

The chronic constriction injury model of mononeuropathy is a direct, partial nerve injury yielding thermal hyperalgesia. The inflammation that results from this injury is believed to contribute importantly to both the neuropathological and behavioral sequelae. This study involved administering a single dose (250 ng) of interleukin-10 (IL-10), an endogenous anti-inflammatory peptide, at the site and time of a chronic constriction injury (CCI) lesion to determine if IL-10 administration could attenuate the inflammatory response of the nerve to CCI and resulting thermal hyperalgesia. In IL-10-treated animals, thermal hyperalgesia was significantly reduced following CCI (days 3, 5 and 9). Histological sections from the peripheral nerve injury site of those animals had decreased cell profiles immunoreactive for ED-1, a marker of recruited macrophages, at both times studied (2 and 5 days post-CCI). IL-10 treatment also decreased cell profiles immunoreactive for the pro-inflammatory cytokine tumor necrosis factor alpha (TNF-alpha) at day 2, but not day 5. Qualitative light microscopic assessment of neuropathology at the lesion site did not suggest substantial differences between IL-10 and vehicle-treated sections. The authors propose that initial production of TNF-alpha and perhaps other proinflammatory cytokines at the peripheral nerve lesion site importantly influences the long-term behavioral outcome of nerve injury, and that IL-10 therapy may accomplish this by downregulating the inflammatory response of the nerve to injury.

During an 18-month period in a burn center (January 1995 through June 1996), 109 single-patient MRSA isolates were identified and 102 isolates (94%) were available for DNA fingerprinting. Ninety-nine isolates (97%) carried the mecA polymorph I and Tn554 type E. Pulsed-field electrophoresis (PFGE) identified 8 patterns, of which 60 isolates were of pattern F2. The I:E:F clonal type and a stable drug multidrug resistant phenotype (sensitivity only to trimethoprim/sulfamethoxazole and vancomycin) indicated that these isolates were closely related to the Iberian clone of MRSA, which is widely spread in Europe. The initial source of I:E:F isolates was sputum 49%, blood 23%, wound 16%, urine 7%, and intravascular catheter tip 5%. Fifty-four percent of patients had smoke inhalation injury, and 51/53 required intubation or tracheostomy. Forty-three isolates were considered invasive (positive blood culture). The overall mortality was 30%. Despite infection control measures, the I:E:F clone continued to be recovered from patients during the 18 months of study. This outbreak is the first known report of the Iberian MRSA clone in the United States