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THE HOT ZONE

What's happening this week:
Hemorrhagic fevers continue to smolder across the globe, as an Ebola outbreak claims 2 more people in the Republic of Congo, and as dengue is declared an emergency in Honduras and neighboring countries. A malaria outbreak in the highlands of Kenya, a non-endemic region, has killed almost 300 people. And West Nile virus has continued its spread across the US, striking the first of 7 human victims this year, a senior in Louisiana. And this week we added a new episode in the always popular Bug of the Month series, "The Case of the Yellow Sub Mariner," by Larry I. Lutwick, MD. You will find links to these and many other articles below. Please send your comments, questions, and suggestions to me at hgoldhagen@webmd.net
Harry Goldhagen, Site Editor, Medscape ID

NEW FEATURES THIS WEEK

MEDSCAPE ORIGINAL ARTICLES
HIV/AIDS JOURNAL SCAN, JULY 2002
Highlights include lopinavir resistance; drug holidays & transmission; identifying primary infection; and HAART in older patients.
Medscape HIV/AIDS 8(2) 2002


CLINICAL CASES FROM JOHNS HOPKINS NEUROLOGY - HEADACHE AND UNILATERAL VISUAL CHANGES
This woman had a rich neurologic history. But what caused these latest symptoms?
Medscape Neurology & Neurosurgery 4(2) 2002


MMWR
RESUMPTION OF ROUTINE SCHEDULE FOR DIPHTHERIA AND TETANUS TOXOIDS AND ACELLULAR PERTUSSIS VACCINE AND FOR MEASLES, MUMPS, AND RUBELLA VACCINE
Supplies of DTaP and MMR vaccines in the US have become sufficient to permit resumption of the routine schedule.
MMWR 51(27) 2002


WEST NILE VIRUS ACTIVITY - UNITED STATES, JULY 3-9, 2002
During this week, the first verified human case of WNV encephalitis in 2002 was reported from Louisiana, in a 78-year-old man.
MMWR 51(27) 2002


DIAGNOSIS AND REPORTING OF HIV AND AIDS IN STATES WITH HIV/AIDS SURVEILLANCE - UNITED STATES, 1994-2000
HIV/AIDS surveillance should be conducted by all states to fully characterize those who need treatment and prevention.
MMWR 51(27) 2002


UPDATE: AIDS - UNITED STATES, 2000
During 1996-2000, AIDS incidence declined or leveled in most geographic regions and among most groups.
MMWR 51(27) 2002


INFECTIONS IN MEDICINE
BUG OF THE MONTH - THE CASE OF THE YELLOW SUB MARINER
What was Dr. Schmeckman's diagnosis of this jaundiced patient?
Infect Med 19(5) 2002


DISAGREEMENT ON HIV RESISTANCE TESTING
Read a letter to the editor concerning a recent AIDS Bulletin column.
Infect Med 19(5) 2002


THE AIDS READER
THE HIV SPECIALIST IMPROVES QUALITY OF CARE AND OUTCOMES
HIV specialists are a diverse group committed to managing this critical evolving epidemic.
AIDS Read 12(5) 2002


OTHER JOURNALS
EMPHYSEMATIOUS CYSTITIS: REVIEW OF CURRENT MANAGEMENT
These 3 patients demonstrated many typical features of emphysematous cystitis.
Infect Urol 15(2) 2002


RECURRENT UTI FOLLOWING SURGERY TO RELIEVE INCONTINENCE
Recurrent UTIs after appropriate antimicrobial therapy should arouse suspicion of a foreign body in the urinary tract.
Infect Urol 15(2) 2002


HEALTH PLANS MOBILIZE NATIONAL BIOTERRORISM RESPONSE
Health plans have focused renewed attention on supporting the efforts of public health agencies and emergency services.
Healthplan 43(3) 2002


 

NEWS

WEST NILE ENCEPHALITIS
THREE LOUISIANA MEN INFECTED WITH WEST NILE VIRUS
Three Louisiana men have become infected with West Nile virus in the nation's first known confirmed cases of the mosquito-borne illness this year, a state health official said on Friday.


MALARIA
MALARIA OUTBREAK KILLS HUNDREDS IN NONENDEMIC AREA OF KENYA
A malaria epidemic affecting Kenya's western districts has killed at least 294 people since June, the government said on Thursday.


RADICAL CURE OF ASYMPTOMATIC MALARIA MAY INCREASE RISK OF SEVERE RECURRENCE
Eliminating falciparum malaria parasites in asymptomatic persons who live in malaria-endemic areas is associated with a greater likelihood of severe symptomatic attacks subsequently, researchers from Ghana report.


MALARIA PARASITE CAN EVOLVE RAPIDLY TO EVADE HOST IMMUNITY, RESIST DRUGS
The human malaria parasite Plasmodium falciparum appears to be much older and more genetically adaptive than previously thought, according to findings from two studies published in the July 18th issue of Nature.


EBOLA VIRUS
TWO MORE SUSPECTED CASES OF EBOLA IN THE REPUBLIC OF CONGO
A total of 8 cases have now been detected in the current outbreak.


DENGUE
HONDURAS DECLARES NATIONAL EMERGENCY OVER DENGUE OUTBREAK
Honduras declared a 'national emergency' on Monday to battle a dengue epidemic that has so far killed a dozen people, mostly children.


VACCINES & IMMUNIZATION
OVER 900 CHINESE CHILDREN HOSPITALIZED AFTER ENCEPHALITIS VACCINATION
Nearly 1000 schoolchildren were rushed to the hospital after being vaccinated for encephalitis in northeast China, and two senior officials were arrested and charged with negligence, local officials said on Friday.


CHILDHOOD VACCINATIONS ARE NOT RELATED TO THE RISK OF ASTHMA
Routine childhood vaccinations--diphtheria, tetanus and whole cell pertussis (DTP), oral polio vaccine, and measles, mumps, and rubella (MMR)--are not associated with the risk of developing asthma, according to a report in the June issue of the Pediatric Infectious Diseases Journal.


MONOCLONAL ANTIBODY INCREASES SURVIVAL FROM PSEUDOMONAS IN MICE
A newly developed monoclonal antibody (MAb) to the PcrV protein of Pseudomonas aeruginosa protects mice against pulmonary infection, sepsis and death in mice, investigators report in The Journal of Infectious Diseases for July 1.


HEPATITIS
28 CASES OF HEPATITIS B LINKED TO INFECTED SURGEON
One surgeon with hepatitis B may have infected up to 28 of his patients with the virus, Dutch researchers report in a recent issue of Infection Control and Hospital Epidemiology.


IRON OVERLOAD, HCV INFECTION PREDICT HEPATIC FIBROSIS WORSENING IN THALASSEMIA
Risk of progression of liver fibrosis in thalassemia patients cured with bone marrow transplantation (BMT) correlates with iron overload and hepatitis C virus (HCV) infection.


POOR SURVIVAL OF HIV/HCV-COINFECTED PATIENTS ATTRIBUTED TO DRUG HEPATOTOXICITY
In patients coinfected with HIV and hepatitis C virus (HCV), the higher risk of death is associated with drug-related hepatotoxicity, not the HCV infection itself, according to a new study.


RISK FACTORS FOR SEVERE HAART-RELATED HEPATOTOXICITY IDENTIFIED
Female sex is one of several factors that may predict which HIV-infected patients treated with highly active antiretroviral therapy (HAART) are likely to develop severe liver enzyme elevations (LEEs).


HIGH TT VIRUS LOAD LINKED TO HEPATOCELLULAR CANCER
High TT virus load independently predicts the development of hepatocellular carcinoma in patients with chronic liver disease related to hepatitis C virus, according to a report in the August Journal of Medical Virology.


PRESENCE OF HBEAG ASSOCIATED WITH INCREASED RISK OF LIVER CANCER
While chronic hepatitis B virus (HBV) infection is a known risk factor for hepatocellular carcinoma, findings from a new study show that the risk is particularly high among subjects positive for hepatitis B e antigen (HBeAg).


HIV-PROTECTIVE CCR5 MUTATION TIED TO HIGHER HEPATITIS C VIRAL LOADS
The 32-base pair deletion in the gene for chemokine receptor 5 (CCR5-delta 32) that protects against HIV infection appears to be an adverse host factor in patients with chronic hepatitis C, according to a report published in the June issue of Gastroenterology.


PEDIATRIC ID
SEVENTEEN INFANTS DIED FROM PERTUSSIS IN US IN 2000
A total of 17 infants died in the year 2000 in the US after contracting whooping cough, according to researchers from the US Centers for Disease Control and Prevention in Atlanta.


CLASSIC MENINGEAL SIGNS NOT USEFUL IN DIAGNOSING MENINGITIS
Three well known signs for meningitis are actually not very useful in diagnosing the condition, according to a report published in the July 1st issue of Clinical Infectious Diseases.


STDS
NOVEL, SINGLE-SESSION COUNSELING TECHNIQUE REDUCES HIGH-RISK SEX BEHAVIOR
A single counseling session, designed to help an individual evaluate self-justifications for high-risk sex behavior, can reduce the risk of future high-risk activity among men who have sex with men, researchers in San Francisco report.


SPECIFIC INTERVENTION REQUIRED TO INCREASE CONDOM USE DURING ORAL SEX
An intervention that addresses specific reasons condoms are not being used during oral sex more than doubled such condom use in brothels in Singapore, according to a new study.


ACYCLOVIR CREAM EFFECTIVE FOR HERPES SIMPLEX LABIALIS
Acyclovir cream is a safe and effective treatment for herpes simplex labialis, but it does not prevent the development of lesions, according to a report published in the July issue of Antimicrobial Agents and Chemotherapy.


INFLUENCE OF EFFECTIVE HIV THERAPY ON HIGH-RISK SEXUAL BEHAVIOR STILL UNCLEAR
The impact of highly active antiretroviral therapy (HAART) on unsafe sexual practices is still a matter of debate.


NOSOCOMIAL INFECTIONS
PATIENT-CONTROLLED ANALGESIA LINKED TO GI SURGICAL SITE INFECTIONS
Infection rate was higher with the pump, but a causal relationship was not established.


EUROPEAN PROPHYLAXIS GUIDELINES PROPOSED FOR OCCUPATIONAL HIV EXPOSURE
Newly formulated guidelines, if adopted, will help standardize the management of occupational exposure to HIV in Europe.


PLASMA IRRADIATION OF MEDICAL EQUIPMENT EXPECTED TO REDUCE NOSOCOMIAL INFECTIONS
German researchers report that a process for sterilizing medical instruments with plasma radiation could reduce nosocomial infections without damaging delicate equipment.


CJD/BSE
J&J SAYS EPREX FORMULATION CHANGE PROBABLY NOT BEHIND ADVERSE EVENTS
Johnson & Johnson said on Wednesday that changes made to the formulation of epoetin alfa as a precaution against variant Creutzfeldt-Jakob disease (vCJD) were unlikely to have triggered the sudden onset of cases of pure red cell aplasia (PRCA).


HIV/AIDS - CLINICAL
HIGH OCCURRENCE OF HIP OSTEONECROSIS SEEN IN HIV-POSITIVE PATIENTS
Osteonecrosis of the hip occurs in more than one in 25 HIV-positive patients, researchers report in the July 2nd issue of the Annals of Internal Medicine.


HIGH CD8+ COUNT, AGE PREDICT SULFONAMIDE SKIN REACTIONS IN PATIENTS WITH AIDS
In patients with AIDS, a high CD8+ cell count and age younger than 36 years are risk factors for sulfonamide-induced skin reactions, according to a report published in the July issue of the Journal of the American Academy of Dermatology.


PHASE I OF FIRST HIV-1 INTEGRASE PROVES SUCCESSFUL
A new antiretroviral candidate is the first in the class of HIV-1 integrase inhibitors to successfully complete a phase I trial, according to a presentation at the XIV International AIDS Conference.


HIV/AIDS - GLOBAL
HAITI PROJECT PROVES FEASIBILITY OF AIDS THERAPY IN DEVELOPING WORLD
The debate over how to get antiretroviral drugs to poor countries has sometimes seemed complicated as experts discussed the issue here this week at the XIV International AIDS Conference, but on Thursday one physician showed how the problem can be tackled in a straightforward and inexpensive way.


HIV INCIDENCE RISING AMONG HOMOSEXUAL MEN IN THE NETHERLANDS
Using a novel testing strategy, Dutch investigators have uncovered an increasing rate of new HIV infections among homosexual men attending a sexually transmitted disease clinic.


MUGABE SEEKS CUBAN HELP IN AFRICA'S WAR ON AIDS
Zimbabwean President Robert Mugabe on Tuesday criticized wealthy nations for ignoring the AIDS pandemic in Africa and welcomed Cuban aid and medical research in combating the disease.


SOUTH AFRICAN PROVINCE GOES IT ALONE ON AIDS THERAPY
One of South Africa's nine provinces has by-passed the national government's policy to launch a pilot programme to treat people living with HIV and AIDS using drugs the state has branded unsafe.


RESOLVE FOR MORE ACTION AS INTERNATIONAL AIDS CONFERENCE CLOSES
Increasing access to care and treatment of HIV infection in the developing world was a central theme of the XIV International AIDS Conference, which was attended by an unprecedented 17,000 delegates from all over the world.


US OFFICIALS ACKNOWLEDGE GLOBAL AIDS ASSISTANCE HAS FALLEN SHORT OF NEED
US officials returning from the International AIDS Conference in Barcelona, Spain, acknowledged that they felt pressure is growing for the US and other wealthy countries to step up their efforts to combat the global AIDS epidemic.


OTHER ID NEWS
TWELVE INDICTED IN TAINTED BLOOD INVESTIGATION IN ITALY
A governmental investigation of HIV and hepatitis infections caused by transfusions of contaminated blood ended on Friday in Trento with the indictment of 12 people, including former representatives of the Italian Ministry of Health.


TOPICAL STEROIDS BETTER THAN ORAL ANTIFUNGALS IN CHRONIC PARONYCHIA
The results suggest that chronic paronychia is dermatitis, not onchyomycosis.


LYME DISEASE VACCINE NOT COST EFFECTIVE FOR MOST INDIVIDUALS
Lyme disease vaccine is cost effective only in the uncommon situation in which an individual is frequently exposed to ticks in a Lyme disease-endemic area, according to a report in the June issue of Arthritis & Rheumatism.


US SENATE SUBCOMMITTEE APPROVES HEALTH SPENDING BILL
The NIH would receive a funding increase of $3.7 billion for the fiscal year that begins October 1, completing a Congressional vow to double the agency's funding over 5 years, under a bill approved by a US Senate subcommittee Tuesday.


US SENATE COMMITTEE APPROVES NOMINATION OF DR. RICHARD CARMONA FOR SURGEON GENERAL
Without debate or dissent, the US Senate Health, Education, Labor and Pensions Committee Wednesday unanimously approved the nomination of Arizona trauma surgeon and deputy sheriff Richard Carmona to be the nation's next Surgeon General.


INNATE DIFFERENCE IN IMMUNE RESPONSE MODULATES ATHEROGENESIS
A genetic variant of the toll-like receptor 4, which mediates inflammatory responses to infection, is associated with a decreased risk for atherosclerosis, according to a report published in the July 18th issue of The New England Journal of Medicine.


BACTERIOPHAGES CONTRIBUTE VIRULENCE FACTORS TO GROUP A STREP
Bacteriophage-like elements incorporated into the DNA of some group A Streptococcus (GAS) strains appear to be at least partially responsible for geographically localized bursts of extreme GAS virulence.



 

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