MEDSCAPE's Infectious Diseases MedPulse

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>>> MEDSCAPE's Infectious Diseases MedPulse(R) <<<

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Cipro information from Bayer Corporation:

For an important message to healthcare professionals regarding anthrax

Exposure and appropriate antibiotic use from the makers of Cipro,

please visit http://www.ciprousa.com/hcp.asp

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MedPulse is a weekly index of key news and features on Medscape's

specialty sites compiled by Medscape's Editors.

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___________________ NEW FEATURE ARTICLES THIS WEEK ____________________

--WEEKLY EPIDEMIOLOGICAL RECORD--

SMALLPOX

A detailed review of smallpox from the WHO.

-- 39TH ANNUAL MEETING OF THE INFECTIOUS DISEASES SOCIETY OF AMERICA --

Concise reviews of the latest findings in infectious disease research,

including:

- Using the Human Genome Project to Understand Disease

- Flu Vaccine Not the Answer to Anthrax Worries

- Where Have All the Drugs and Vaccines Gone?

- What's Hot? Anthrax

- Changing Epidemiology of Bacterial Meningitis

- New Tools for Kala-Azar

- Understanding Gastrointestinal Infections

- Hemorrhagic Fever Viruses: Apocalyptic Agents?

Complete coverage of the conference, including a series of reviews on

HIV/AIDS, can be viewed at:

http://www.medscape.com/IDSA2001

-- MEDSCAPE ORIGINAL ARTICLES --

EDITORIAL - ANESTHESIOLOGY & PHARMACOTHERAPY: AN INVITATION TO AUTHORS

AND READERS

To help serve our members in a more specific way, we are proud to

announce 2 new sections.

MedGenMed, November 1, 2001

http://id.medscape.com/44512.rhtml?srcmp=id-110201

-- INFECTIONS in MEDICINE --

SHOULD ALL ADOLESCENTS AND ADULTS BE VACCINATED AGAINST PERTUSSIS?

Although the incidence of pertussis in North America declined by more than 90% during the last half century as a result of universal childhood pertussis immunization, there has been a steady increase in cases during the last decade.

Infect Med 18(10):473-475, 2001

http://id.medscape.com/44497.rhtml?srcmp=id-110201

-- SOUTHERN MEDICAL JOURNAL --

SUCCESSFUL TREATMENT OF CRYPTOCOCCAL OSTEOMYELITIS AND PARASPINOUS ABSCESS WITH FLUCONAZOLE AND FLUCYTOSINE

A patient with thoracic cryptococcal osteomyelitis was treated successfully with the combination of fluconazole and flucytosine.

http://id.medscape.com/44561.rhtml?srcmp=id-110201

-- OTHER JOURNALS --

MEDICAL-LEGAL ISSUES IN HIV TREATMENT: PART 2

Medical practitioners and institutions face frequent challenges when treating HIV-positive patients. These challenges are exacerbated when, as is often the case, the patient is also an inmate in a correctional facility.

The AIDS Reader 11(9):432-441, 2001

http://id.medscape.com/44506.rhtml?srcmp=id-110201

TELITHROMYCIN: AN ORAL KETOLIDE FOR RESPIRATORY INFECTIONS

The ketolides represent a new subclass of antibiotics among the macrolide-lincosamide-streptogramin group.

Pharmacotherapy 21(10):1204-1222, 2001

http://id.medscape.com/44560.rhtml?srcmp=id-110201

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___________________________________ NEWS ______________________________

BIOTERRORISM RESOURCE CENTER

Visit this collection of the latest information on bioterrorism and resources for recognizing and treating potential biowarfare attacks.

http://www.medscape.com/mp/rc/bioterrorism

-- ANTHRAX: FATAL NYC CASE --

CLUES SOUGHT IN BAFFLING NEW YORK ANTHRAX DEATH

Frantically seeking clues in the death of a New York hospital worker, investigators sought on Thursday to retrace the steps of the Vietnamese immigrant who became the fourth person in a month to die from anthrax.

http://id.medscape.com/44592.rhtml?srcmp=id-110201

OFFICIALS STRUGGLE TO EXPLAIN INHALATIONAL ANTHRAX CASE IN NEW YORK

The latest case of anthrax, in a New York hospital employee who died early on Wednesday, has authorities scrambling to determine whether mail going to ordinary people could be contaminated with the bacterial spores.

http://id.medscape.com/44548.rhtml?srcmp=id-110201

NEW YORK HOSPITAL WORKER DIES OF ANTHRAX

A New York hospital worker died early on Wednesday from inhalation anthrax, becoming the fourth person to die of anthrax in the US this month, city officials said.

http://id.medscape.com/44549.rhtml?srcmp=id-110201

AUTHORITIES INVESTIGATE POSSIBLE INHALATION ANTHRAX CASE IN NEW YORK

Authorities awaited confirmation on Tuesday of a preliminary diagnosis of inhalation anthrax in a critically ill hospital employee in New York.

http://id.medscape.com/44456.rhtml?srcmp=id-110201

-- ANTHRAX: US OUTBREAKS --

ANTHRAX DETECTED AT CIA MAIL FACILITY

A mail processing facility on the grounds of the US Central Intelligence Agency compound in Langley, Virginia, was closed on Friday for testing and cleaning after test results returned on Thursday confirmed there was a 'trace amount' of anthrax in the building.

http://id.medscape.com/44339.rhtml?srcmp=id-110201

HOSPITALIZED CONGRESSIONAL REPORTER TESTS NEGATIVE FOR ANTHRAX

A US congressional reporter hospitalized for possible anthrax infection has no trace of the potentially deadly bacteria, authorities said on Friday.

http://id.medscape.com/44344.rhtml?srcmp=id-110201

ANTHRAX FORCES VENUE CHANGE FOR US HIGH COURT

The justices of America's highest court were poised on Monday to hear legal arguments away from the Supreme Court building for the first time since it was built in 1935 as the anthrax scare made its latest impact on the institutions of the United States.

http://id.medscape.com/44398.rhtml?srcmp=id-110201

ANTHRAX DETECTED IN FDA BUILDING; CIVILIAN MAIL SAID TO BE SAFE

Bush administration officials confirmed Friday that anthrax spores had

been detected in the main State Department building and in the downtown

headquarters of the Food and Drug Administration.

http://id.medscape.com/44403.rhtml?srcmp=id-110201

ANTHRAX FOUND IN 4 FDA MAILROOMS, EARLY TESTS SHOW

Mailrooms at four US Food and Drug Administration buildings in and around Rockville, Maryland, have tested positive for anthrax in preliminary tests, an agency spokesman said on Thursday.

http://id.medscape.com/44594.rhtml?srcmp=id-110201

-- ANTHRAX: TREATMENT & PROPHYLAXIS --

FDA SUGGESTS DOXYCYCLINE, PENICILLIN G PROCAINE DOSES FOR INHALATION

ANTHRAX

The US FDA clarified Tuesday that doxycycline and penicillin G procaine are already approved for treatment of all forms of anthrax infections, including inhalation anthrax.

http://id.medscape.com/44463.rhtml?srcmp=id-110201

MASS PROPHYLAXIS FOR ANTHRAX COULD LEAD TO DRUG-RESISTANT PATHOGENS

Indiscriminate, prolonged antimicrobial prophylactic treatment of anthrax may lead to drug resistance in commensal bacteria, UK scientists warn.

http://id.medscape.com/44591.rhtml?srcmp=id-110201

PERIPHERAL NEUROPATHY ASSOCIATED WITH CIPRO

Adverse effects associated with the use of ciprofloxacin and other fluoroquinolone antibiotics are not always benign.

http://id.medscape.com/44557.rhtml?srcmp=id-110201

US DECIDES TO ISSUE ANTHRAX VACCINE

Decontamination personnel and hundreds of state and private laboratory workers, on the front line of the anthrax scare, will be eligible for vaccination against the germ warfare agent, the CDC said on Friday.

http://id.medscape.com/44400.rhtml?srcmp=id-110201

BMA CONDEMNS WEB SITES OFFERING CIPRO

The British Medical Association on Tuesday expressed concern at the proliferation of Web sites capitalizing on the anthrax scare by offering Bayer's Cipro direct to consumers.

http://id.medscape.com/44454.rhtml?srcmp=id-110201

ANTHRAX MICROBICIDE MAY SOON BE AVAILABLE IN AUSTRIA

Austrian doctors say they have developed a spray that kills anthrax bacteria without causing any side effects to individuals exposed to the agent.

http://id.medscape.com/44532.rhtml?srcmp=id-110201

-- ANTHRAX & THE US POSTAL SYSTEM --

CDC DIRECTOR SAYS INADVERTENT ANTHRAX CONTAMINATION OF MAIL IS UNLIKELY

The director of the US CDC, Dr. Jeffrey Koplan, told reporters during a telephone briefing Friday that his 'working hypothesis' is that anthrax spores do not spread from a 'criminal mailing' to another piece of mail.

http://id.medscape.com/44341.rhtml?srcmp=id-110201

IRRADIATING MAIL TO KILL ANTHRAX SEEN AS COSTLY

The threat of anthrax in letters can be countered by bombarding mail with high-energy beams, but scientists say machines are costly and few are available.

http://id.medscape.com/44343.rhtml?srcmp=id-110201

POSTAL WORKERS TOLD TO TAKE CIPRO ALTERNATIVE

Some US postal workers have started to take doxycycline, a less expensive alternative to ciprofloxacin, after getting the green light over the weekend from federal health officials, the US Postal Service said.

http://id.medscape.com/44399.rhtml?srcmp=id-110201

-- SMALLPOX --

WHO RULES OUT MASS SMALLPOX VACCINATION

The World Health Organization said on Friday that it remains opposed to mass inoculations for smallpox despite fears the virus could be used as a weapon of biowarfare.

http://id.medscape.com/44342.rhtml?srcmp=id-110201

MAJOR DRUGMAKERS HOPE TO SUPPLY US GOVERNMENT WITH SMALLPOX VACCINE

GlaxoSmithKline said on Friday that it would seek to begin manufacturing smallpox vaccine to help prepare the United States for the possibility that the disease could be used in a bioterrorist attack.

http://id.medscape.com/44392.rhtml?srcmp=id-110201

-- BIOTERRORISM PREPAREDNESS --

PANEL TO PROPOSE NATIONAL VACCINE LABORATORY

A special US commission on terrorism will recommend that President Bush and Congress establish a national laboratory to create vaccines to combat biological threats, its chairman said on Wednesday.

http://id.medscape.com/44579.rhtml?srcmp=id-110201

EARLY WARNING BIOTERRORISM SYSTEMS URGED

The key to detecting a large-scale bioterrorism attack early is an electronic surveillance system, one that does not require major data entry by providers, that could link hospitals, public health departments and laboratories, witnesses told a House subcommittee on Thursday.

http://id.medscape.com/44580.rhtml?srcmp=id-110201

HOSPITALS SEEK $11.3 BILLION TO ENSURE PREPAREDNESS FOR TERRORIST

ATTACKS

The nation's 4900 hospitals are asking Congress for $11.3 billion to help them ensure they are fully ready for a nuclear, biological or chemical attack, the American Hospital Association said on Thursday.

http://id.medscape.com/44581.rhtml?srcmp=id-110201

PUBLIC HEALTH EXPERT SAYS FUNDS NEEDED AS BIOLOGICAL ATTACKS LOOM

State and local public health departments need immediate federal funding of about $1 billion to guard against the risk of widespread fatalities that could stem from biological attacks in the US, a leading national public health official said on Tuesday.

http://id.medscape.com/44457.rhtml?srcmp=id-110201

GERMAN OFFICIALS SAY COUNTRY IS PREPARED FOR BIOWEAPON ATTACK

Germany would be able to respond effectively to any major medical emergencies posed by a bioweapon attack, according to a spokeswoman for the Robert Koch-Institute, the Germany equivalent of the US CDC.

http://id.medscape.com/44459.rhtml?srcmp=id-110201

GENOMIC DATA MAY BE DANGEROUS IN WRONG HANDS

While recent advances in the field of molecular biology have brought a flood of scientific achievement, namely the sequencing of the entire human genome, some scientists are worried that genomics could be used to create a new generation of biological weapons.

http://id.medscape.com/44593.rhtml?srcmp=id-110201

-- BIOTERRORISM POLICY ISSUES --

ANTHRAX SPOTLIGHTS US STAND ON WTO DRUG RULES

The US decision to strike a deal with Bayer AG to buy discounted Cipro, rather than issue licenses for generic copies of the anthrax-fighting drug, has thrown a spotlight on world trade rules that critics say block poor countries' access to lifesaving medicines.

http://id.medscape.com/44326.rhtml?srcmp=id-110201

US DRUGMAKERS PLEDGE TO SUPPLY NATION WITH FREE ANTIBIOTICS, ACCESS TO EXPERTS

The US government may soon have access to an abundance of antibiotics, scientific experts and vaccines at no cost to the American public.

http://id.medscape.com/44538.rhtml?srcmp=id-110201

-- WEST NILE ENCEPHALITIS --

DNA VACCINE SHOWS PROMISE AGAINST WEST NILE VIRUS

A new DNA vaccine against West Nile virus prompts strong T-cell-mediated responses in mice, researchers report in the October 1st issue of the Journal of Infectious Diseases.

http://id.medscape.com/44324.rhtml?srcmp=id-110201

VACCINE PREVENTS WEST NILE VIRUS INFECTION IN MICE

The West Nile virus envelope protein has been used successfully to immunize mice and protect them from infection, according to a report in the November 1st issue of the Journal of Immunology.

http://id.medscape.com/44554.rhtml?srcmp=id-110201

-- TUBERCULOSIS --

TUBERCULOSIS CAN SPREAD FROM JAIL TO SURROUNDING COMMUNITY

Within a short time after a tuberculosis outbreak within a large urban jail, the Mycobacterium tuberculosis strain involved spread to the surrounding community, according a presentation at the 39th Annual Meeting of the Infectious Diseases Society of America in San Francisco.

http://id.medscape.com/44327.rhtml?srcmp=id-110201

NEW TB VACCINE WORKS IN PRE- AND POST-EXPOSURE SETTING

A new recombinant vaccine of bacillus Calmette-Guerin (BCG) increases survival in both a pre-exposure and post-exposure setting, according to data from an animal model study presented at the 39th annual meeting of the Infectious Diseases Society of America in San Francisco on Saturday.

http://id.medscape.com/44388.rhtml?srcmp=id-110201

AIDS PATIENTS WITH EXTRAPULMONARY TB HAVE HIGH MORBIDITY

Compared to AIDS patients with pulmonary tuberculosis (TB), AIDS patients with extrapulmonary TB tend to have a more complicated medical course, according to an epidemiological analysis.

http://id.medscape.com/44390.rhtml?srcmp=id-110201

-- INFLUENZA --

ANTHRAX CONCERNS SPUR MORE INFLUENZA VACCINE PRODUCTION

Influenza vaccine makers said Friday that they would produce extra vaccine doses in response to growing concerns that flu cases this winter will be confused with anthrax.

http://id.medscape.com/44345.rhtml?srcmp=id-110201

EXTRA PATIENT EDUCATION MAY BE NEEDED THIS FLU SEASON

Patients need to be advised that the influenza vaccine will help protect them against the flu, but not against anthrax, officials at the US CDC said in a teleconference on Wednesday.

http://id.medscape.com/44550.rhtml?srcmp=id-110201

-- VACCINES --

PNEUMOCOCCAL CONJUGATE VACCINE HIGHLY EFFECTIVE IN YOUNG CHILDREN

The 7-valent pneumococcal conjugate vaccine (PNCV7) greatly reduces the disease burden due to Streptococcus pneumoniae in children younger than 5, according to a presentation at the 39th Annual Meeting of the Infectious Diseases Society of America, being held in San Francisco.

http://id.medscape.com/44346.rhtml?srcmp=id-110201

US VACCINE COMPENSATION PROGRAM COMES UNDER SCRUTINY

A federal program designed to compensate families for the adverse effects of vaccines has in some cases become just as contentious as the disputes it was meant to avoid, several witnesses told lawmakers Thursday.

http://id.medscape.com/44578.rhtml?srcmp=id-110201

FDA URGED TO CONSIDER BANNING PRODUCTS MADE WITH BOVINE CNS TISSUE

The Transmissible Spongiform Encephalopathies Advisory Committee to the US FDA voted 18 to 1 on Friday to urge the agency to consider a ban or restriction on the sale of products containing bovine brain or spinal tissue, whether made abroad or in the US.

http://id.medscape.com/44348.rhtml?srcmp=id-110201

-- HEPATITIS --

DAILY INJECTION MORE EFFECTIVE THAN THRICE-WEEKLY INTERFERON ALPHA-2B FOR HCV/HIV

For patients co-infected with HIV and the hepatitis C virus (HCV), daily administration of interferon alpha-2b is more than twice as effective as the traditional three times/week regimen in suppressing HCV loads.

http://id.medscape.com/44384.rhtml?srcmp=id-110201

-- GI DISEASE --

SHIGELLOSIS OUTBREAK AMONG GAY MEN IN SAN FRANCISCO WAS DUE TO S. SONNEI

From June to December 2000, the number of Shigella sonnei infections reported in San Francisco increased by more than tenfold compared with previous years, predominantly among men who have sex with men, according to the US CDC.

http://id.medscape.com/44331.rhtml?srcmp=id-110201

SCOTTISH E. COLI OUTBREAK YIELDS CLUES TO HEMOLYTIC UREMIC SYNDROME RISK

A 1996 outbreak of Escherichia coli O157:H7 in central Scotland has provided UK researchers with a clear picture of risk factors leading to hemolytic uremic syndrome.

http://id.medscape.com/44449.rhtml?srcmp=id-110201

-- OTHER ID NEWS --

INVESTIGATIONAL DRUG TO TREAT SEPSIS RECEIVES FDA APPROVABLE LETTER

Eli Lilly has received an approvable letter from the US FDA for its sepsis drug Xigris (drotrecogin alfa), the firm said on Monday.

http://id.medscape.com/44462.rhtml?srcmp=id-110201

FEVER WITH POLYARTHRITIS CAN BE DUE TO BRUCELLOSIS

Researchers from India recommend that brucellosis should be considered in the differential diagnosis of patients presenting with fever and polyarthritis.

http://id.medscape.com/44321.rhtml?srcmp=id-110201

AMERICAN PARENTS ILL-INFORMED ABOUT THE COMMON COLD

Parents of young children still hold many incorrect notions about the way the common cold is transmitted, Harvard researchers reported here Friday at the annual meeting of the Infectious Diseases Society of America.

http://id.medscape.com/44402.rhtml?srcmp=id-110201

ADENO-ASSOCIATED VIRUS INFECTION LINKED TO MALE INFERTILITY

Infertile men are more likely to harbor adeno-associated virus DNA in their semen than men without an infertility history, according to a report published in the October 26th issue of Human Reproduction.

http://id.medscape.com/44441.rhtml?srcmp=id-110201

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_______________________________ MEMBER NEWS ___________________________

BIOTERRORISM RESOURCE CENTER: ARE WE PREPARED FOR A BIO-TERRORIST

ATTACK?

http://www.medscape.com/mp/rc/bioterrorism

ANTHRAX: WHAT EVERY CLINICIAN SHOULD KNOW

This recording of the live webcast from the CDC presents clinical guidelines and procedures for the early recognition, diagnosis, treatment, and reporting of anthrax exposure. A panel of experts from the CDC provide an overview of clinical, laboratory and public health preparedness for potential Bacillus anthracis incidence. Sponsored by the American Hospital Assn., American Medical Assn., Public HealthTraining Network, CDC, and the University of North Carolina School of Public Health.

http://www.medscape.com/webcast/anthrax

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