Subject: CDC Summary 3/1/93 Date: Mon, 01 Mar 1993 08:56:46 PST (210 lines) Archive-Number: 294 Archives of Internal Medicine. Researchers from the University of From: Billi Goldberg Note: Copyright 1992, Dan R. Greening. Non-commercial reproduction allowed. sold. Copyright 1992, Information, Inc., Bethesda, MD AIDS Daily Summary March 1, 1993 The Centers for Disease Control and Prevention (CDC) National AIDS Clearinghouse makes available the following information as a public service only. Providing this information does not constitute endorsement by the CDC, the CDC Clearinghouse, or any other organization. Reproduction of this text is encouraged; however, copies may not be sold. Copyright 1992, Information, Inc., Bethesda, MD =================================================================== "Patents: Glove Designed for Medical Work" New York Times (03/01/93), P. D2 (Chartrand, Sabra) A newly-developed glove can protect health-care workers from sticking themselves with tainted needles. The device is made of leather with a pore size smaller than the diameter of a needle, and it has a second layer of leather over the glove's thumb, index finger, and middle finger. Most accidental needle sticks occur on the thumb, forefinger, and in the area between the thumb and forefinger, said Joseph A. Stern, a biologist in Hampton, Va. Although used needles should be disposed of without being touched, Stern said studies show that health-care workers often return used needles to their plastic packaging before discarding them. He said, "That's where many of the sticks come from." The patent for the glove cites a study of 202 New York city surgeons which found that 86 percent reported sticking themselves at least once a year, mostly in the index finger. The layered leather glove could further protect against such accidents. The glove is available with an optional fingertip opening, allowing technicians who draw blood to easily feel for a patient's veins. This flap can be reclosed before the technician handles the needle. Stern said, "It's a little awkward, because you have a second layer of material, making it not quite as flexible as latex gloves. But if all students in medical school used it, by the time they got out to practice medicine they would be accustomed to it." =================================================================== "J&J Unit to Test New AIDS Drug in Mix With Others" Wall Street Journal (03/01/93), P. B8 (Waldholz, Michael) A new anti-AIDS drug is currently being tested in humans by scientists at Johnson & Johnson 's Belgian drug research operation. The drug, called alpha-APA, has been effective in inhibiting HIV replication in test tube studies. Also, in initial human tests, the drug appeared safe. However, the drug's developers said in an interview last week that the drug doesn't appear to be effective against HIV infection on its own, and will be tested later this year in combination with other antiviral AIDS drugs already available or being tested. The researchers who are developing alpha-APA at Janssen Pharmaceutica in Beerse, Belgium, said the drug functions in a manner similar to a class of experimental drugs developed by Merck & Co. and Boehringer Ingelheim Corp., to which HIV subsequently became resistant. The Janssen researchers reported their findings in today's issue of the Proceedings of the National Academy of Science. The report said test tube studies indicate that HIV will also develop quick resistance to alpha-APA if used alone. The alpha-APA drug and those developed by Merck and Boehringer Ingelheim function by blocking the action of reverse transcriptase, an enzyme crucial to the life cycle of HIV. =================================================================== "Hemophilia Drug" Associated Press (02/25/93) Washington--A blood-clotting drug has received Food and Drug Administration approval to be used by patients with hemophilia A, according to its manufacturer, Miles Inc. of West Haven, Conn. The company said that the FDA has approved sale of a drug called Kogenate that prevents bleeding. Kogenate replaces a substance called factor VIII that is absent or in short supply in the blood of patients with hemophilia A. The blood will not clot naturally without the factor, and uncontrolled bleeding will result. Miles revealed that Kogenate was produced through the use of recombinant DNA techniques. This approach involves altering the genes of a bacteria to force it to make the desired substance. Hemophiliacs previously were treated only with factor VIII that had been removed from human blood. This technique entails the processing of thousands of units of blood for one dose of the factor. In the 1980s, before blood could be screened for HIV, many hemophiliacs contracted HIV through contaminated factor VIII injections. Kogenate prevents anyone from becoming infected with HIV because it is synthetic. =================================================================== "France Offers Full State Health Cover for AIDS" Reuters (02/26/93) Paris--All AIDS patients and people with HIV infection in France will be fully compensated for their disease by the country's state social security system, Health Minister Bernard Kouchner announced Friday. "We have decided to offer 100 percent health cover to all HIV- positive people who want it, as of today," said Kouchner. He added that the patient's condition would remain confidential. Condom distribution machines will also be installed in high schools, said Education and Culture Minister Jack Lang. "More than 50 percent of high school students say they have sexual relations. It's a fact ... protecting kids from this deadly risk is imperative," said Lang. Last week, a special panel of doctors recommended the compensation plan, which has also been a major demand of AIDS activists. France has one of the highest rates of HIV infection in Europe. As of September 1992, the country had 24,000 diagnosed AIDS cases and as many as 200,000 people infected with HIV. The announcement allayed the fears of many AIDS activists, who worried that the center-right government likely to win power next month would implement unfavorable policies such as mandatory HIV testing. AIDS, however, is not mentioned in the opposition's manifesto, and it is unknown what the new government's policy and response to Kouchner's plan would be. =================================================================== "Clinton Delays Naming 'AIDS Czar'" New York Times (02/28/93), P. 24 (Berke, Richard L.) President Clinton still has not fulfilled his campaign promise to appoint an "AIDS czar" because of differences among his advisers over how the position should be structured and who should get the job. According to White House officials, Clinton still expects to appoint a coordinator of federal efforts to fight AIDS, called an "AIDS czar." However, the time it is taking to fill the post has led AIDS activists to conclude that Clinton has not made fighting AIDS a top priority. Several senior White House officials have revealed that two likely candidates for the position are New York City Health Commissioner Margaret A. Hamburg and Gov. Lowell P. Weicker Jr. of Connecticut. Hamburg is considered a policy expert who is acquainted with the nuances of health care but has no political experience. Weicker, a former Republican and now an independent, was an outspoken supporter of anti-AIDS efforts while he was in the Senate. He is more well-known than Hamburg, and is viewed as someone who would travel the nation lobbying the issue. Among those involved in the debate over the position are Donna E. Shalala, the Secretary of Health and Human Services, and Bob Hattoy, who addressed the Democratic National Convention about his HIV infection and is now working in the White House personnel office. Administration officials said they were struggling to determine how to pay for the position, because Clinton has promised to reduce White House staff. A possible solution would be to include the position in the budget of the Department of Health and Human Services, say officials. =================================================================== "Weicker Ducks Questions About Becoming U.S. AIDS Policy Head" New York Times (03/01/93), P. B7 Reports that Connecticut Gov. Lowell P. Weicker Jr. may be appointed as the Clinton Administration's AIDS czar have not been confirmed by the governor, according to Lieutenant Gov. Eunice S. Groark. She said yesterday that she had asked the governor last week about reports that President Clinton was considering him for the federal AIDS czar position. Groark said, "He went 'Hmmmm,'" and added nothing more. She also said that she was unaware of Weicker's contacts with the Clinton administration, aside from reports of his having been considered for other high-ranking positions. She said, "There was no great comment about it," between Weicker and herself. "I wouldn't read very much into that. I think he would be a likely candidate," she added. Beth Weinstein, the director of AIDS programs in the State Department of Health Services, said Weicker's name had been mentioned in conversations among her counterparts in other states. "People have known for a while that he has been mentioned as a candidate," she said. =================================================================== "Support for AIDS Project" Financial Times (03/01/93), P. 10 (Summers, Diane) A training video that addresses concerns about AIDS has been developed by Terrence Higgins Trust in the United Kingdom, in partnership with a coalition of large companies. Those corporations which support the training project include IBM, Marks and Spencer, Unilever, Kingfisher, and WH Smith. In addition to the video, the project has published an AIDS training manual and briefing notes, covering basic medical information, recruitment issues, confidentiality, pensions, first aid, and travel abroad. Also, the Society of Occupational Medicine has produced an AIDS booklet that covers many of the same issues, and provides a good introduction to the disease. Although European companies have been slower to address AIDS in the workplace, the latest training material should create more interest in the issue. =================================================================== "Mixed Sentiments" American Medical News (02/22/93) Vol. 36, No. 8, P. 22 Americans seem to be more accepting of HIV-positive health-care workers who remain on the job, according to a study published in the Archives of Internal Medicine. Researchers from the University of California--San Francisco found that 54 percent of those surveyed in 1991 said HIV-positive surgeons should stop working, whereas, in 1988, the figure was 59 percent. Those who disapproved of infected physicians who continued to work dropped from 45 percent to 39 percent, and for dentists the percentage dropped from 52 percent to 47 percent. The 1991 survey involved 1,350 adults, of whom 85 percent supported mandatory HIV testing for surgeons. About 79 percent of the respondents favored such testing for all physicians, and 78 percent for dentists. Although 1993 percent said health-care workers should be compelled to disclose their HIV-positive status to patients, only 6 percent said they had ever been told. =================================================================== "AIDS Patient Claims Hospital Violated ADA, 'Dumping' Law" American Medical News (02/22/93) Vol. 36, No. 8, P. 13 (McCormick, Brian) An AIDS patient who alleges he was discriminated against when being admitted to a hospital has filed suit saying the hospital violated two laws. The case has prompted an influx of independent government reviews. Officials are attempting to find out whether the patient's transfer from Memorial Hospital in Fremont, Ohio, violated the Americans With Disabilities Act or the 1986 Emergency Medical Treatment and Active Labor Act, also known as the "anti-dumping" law. The hospital and the doctor say that the lawsuit is unwarranted because the patient received sufficient care. The providers claim that the patient, Fred Charon, was transferred because the hospital was ill- equipped to treat his rare skin disorder, not because of his HIV status. Charon filed suit last year against the hospital and Dr. Charles Hull, who was supervising the emergency department when Charon sought treatment in April 1992. Charon was first diagnosed with toxic epidermal necrolysis when he was first admitted to the ED. The diagnosis was subsequently changed. Charon was transferred to the Medical College of Ohio Hospital in Toledo, nearly an hour away. The complaint says that AIDS was the reason. A note in the medical record quotes Dr. Hull as ordering the transfer saying "If you get an AIDS patient in the hospital, you will never get him out." Dr. Hull said, "Optimal treatment of this patient called for a burn unit, which we don't have. It also required specialists--such as a dermatologist and an infectious disease specialist--which we don't have." However, a lawyer representing Charon through the American Civil Liberties Union said the hospital was fully capable of treating Charon's condition.