The CDC National Center for HIV, STD, and TB Prevention provides the following information as a public service only. Providing synopses of key scientific articles and lay media reports on HIV/AIDS, other sexually transmitted diseases and tuberculosis does not constitute CDC endorsement. This daily update also includes information from CDC and other government agencies, such as background on Morbidity and Mortality Weekly Report (MMWR) articles, fact sheets, press releases, and announcements. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC HIV/STD/TB Prevention News Update should be cited as the source of the information. Contact the sources of the articles abstracted below for full texts of the articles.
Nature--Impacts of Foreseeable Science Supplement (12/02/99)
Vol. 402, No. 6761, P. C63; Bloom, Barry R.
Barry Bloom of the Harvard School of Public Health discusses the
future of public health in a fact-based article on improvements
made during this century in health. He lists the fact that half
of all the increases in life expectancy ever have occurred during
this century, as average lifespans went from 47 years in 1900 to
78 years in 1995. However, disparities remain between the rich
and the poor and their relative lifespans, although much
improvement was also made in that area. The major advancements
of the century stem from the impact of public health and disease
prevention, not intervention. By focusing on prevention, public
health can reach masses of people and achieve impressive results,
such as reducing heart attack and stroke deaths by 50 percent.
The success of vaccines is a chief reason for the health gains,
as smallpox was eradicated and polio is nearing elimination
through the use of vaccines. Vaccines are still the most
cost-effective way to prevent death and disease, Bloom notes, and
for the first time, infectious diseases are not the largest cause
of death in the world. Still, disparities between the public
health of countries and even counties within the United States
exist. Four areas that Bloom would like to see public health
improve are: more sensitive epidemiological approaches for risk
factors with better trials; better disease surveillance; better
understanding of the burdens and costs of interventions; and
development of a public health approach that protects populations
and has prevention strategies for large groups, not just a few
individuals. He adds that effective vaccines against AIDS,
malaria, tuberculosis, dysentery, and other respiratory and
diarrheal diseases must still be developed.
Journal of Infectious Diseases Online (12/99) Vol. 180,
No. 6, P. 1757; Gauthier, Josee; Bourne, Eric J.; Lutz,
Michael W.; et al.
Researchers from Glaxo Wellcome and Massachusetts General
Hospital in Boston conducted a phase II study of extended
lamivudine therapy to assess hepatitis B viremia and the
emergence of hepatitis B virus (HBV) YMDD variants with reduced
susceptibility to lamivudine. After being treating with
lamivudine for 12 weeks, all patients experienced a 99 percent
decrease in serum HBV DNA levels. During therapy, detectable
YMDD variants emerged in 10 patients, and six subjects saw
hepatitis B e antigen seroconversion while taking lamivudine. No
patients with HPV DNA levels about 10(4) genomes/mL
seroconverted. According to the researchers, the study shows
that patients who experience significant decreases in viral DNA
level while taking lamivudine are at a higher risk of
seronconverting than patients who do reach this level of HBV
clearance.
"Teen Drug Use"
USA Today (12/20/99) P. 6D; Healy, Michelle
A new government report shows that drug use among teenagers
remained stable in 1998. The "Monitoring the Future" survey
found the third straight year of no increase in the use of
marijuana, cocaine, heroin, and inhalants. According to the
survey, however, more high school students have been taking
steroids and Ecstasy. Alcohol use was stable overall, but there
was a slight decline in daily alcohol consumption by high school
seniors.
Chicago Tribune (12/18/99) P. 1; Van, Jon
Researchers at Argonne National Laboratory are working with
Russian scientists in an effort to combat tuberculosis (TB). The
teams hope to develop inexpensive microchips that can rapidly
identify the specific strain of TB affecting a patient. The
microchips, which would use the patients' genetic material, could
help in the selection of the most effective therapy because the
biochips could determine whether the microbe in question is
resistant to certain drugs. Experts note that diagnostic
biochips for TB are already on the market, but their high
cost--$50 and up--is prohibitive for Russia and other
cash-strapped nations.
"Number of Older Americans With HIV on the Upswing"
Houston Chronicle (12/19/99) P. A1; Kever, Jeannie
An increasing number of senior citizens are living with HIV in
the United States. In part, this is the result new drugs that
have helped people to live longer. However, some individuals are
becoming infected later in life, perhaps believing that their
advanced age will guard against an infection often linked to drug
abuse, prostitution, and other risk factors. Statistics show
that about 11 percent of reported AIDS cases are among people 50
years of age and higher. While a great deal of attention has
been paid to falling rates of HIV infection among children,
experts point out that little has been said about older
Americans. Marcia Ory, head of social science research on aging
at the National Institute on Aging, noted, "The point is that
society cannot ignore AIDS in that pediatric population, in the
young adult population, or the older population."
"Florida Marketing Campaign: HIV Prevention"
Houston Chronicle (12/19/99) P. A26; Kever, Jeannie
The Senior HIV Intervention Project, or SHIP, was created two
years ago by the Florida Department of Health and the Department
of Elder Affairs as a result of higher-than-average rates of AIDS
among seniors in the state. The program uses speakers who are
all at least 50 years old to tell people that HIV is dangerous
but that it also can be prevented. SHIP focuses on condominium
complexes, retirement centers, assisted living facilities, and
nursing homes in Dade, Broward, and Palm Beach counties. To
attract seniors to the discussions, SHIP coordinator John
Gargotta notes that marketing is important, promoting the
meetings as "Sexuality in the Golden Years," for example, rather
than only an HIV/AIDS seminar.
Detroit News Online (12/19/99); Webster, Sarah A.
The failure to properly sterilize medical equipment at two
Michigan hospitals has forced 23 patients to return for
infectious disease tests, including one for HIV. Sterilization
machines at the two facilities apparently did not kill bacteria
on various instruments, which were used again on patients before
bacteria test results were available. Citing patient
confidentiality, the hospitals--both within the Oakwood
Healthcare System--have not specified whether the patients were
exposed to HIV, hepatitis B, or hepatitis C; however, an
administrator noted that the risk of infection was extremely low.
"[Needle Exchange in Fresno County]"
Los Angeles Times Online (12/18/99)
In Fresno County, California, activists hope to get county
officials to declare a local medical emergency so injection drug
users could legally exchange used hypodermic needles for new
ones. A law signed by California Governor Gray Davis earlier
this year allows local governments to declare medical emergencies
as the result of public health threats. Tony Mello, founder of
the San Joaquin Valley Exchange Works, which distributes needles
in the region, asserts that, with 15,000 injection drug addicts
in the county, a medical crisis does indeed exist. Mello will
ask county officials to declare an emergency at a meeting next
month.