Subject: CDC AIDS DAILY SUMMARY 01/07/94 Date: Fri, 07 Jan 1994 09:41:24 CST (182 lines) Approved: phil (J. Philip Miller) Archive-number: 12411 From: "ANNE WILSON, CDC NAC" Note: Copyright 1994, Dan R. Greening. Non-commercial reproduction allowed. Copyright 1993, Information, Inc., Bethesda, MD AIDS Daily Summary January 07, 1994 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, and the CDC Clearinghouse should be cited as the source of this information. Copyright 1993, Information, Inc., Bethesda, MD "Doctors Not Asking About Patients' Sexual History" United Press International (01/06/94) (Taylor, Charles S.) Atlanta--Although AIDS has evolved into a major cause of death for young Americans, federal health officials say many doctors miss an opportunity to help prevent the disease by neglecting to interview patients about their sexual histories. According to a 1992 survey of 2,545 primary care physicians, the Centers for Disease Control found that doctors are likely to ask about the smoking habits of new adult and adolescent patients, but questions concerning sexual history were less frequent. Almost all of the respondents, 94 percent, reported asking new patients over age 19 about cigarette smoking. Yet less than half, 49 percent, asked about sexually transmitted diseases. Only 31 percent asked about condom use, 27 percent about sexual orientation, and 22 percent about the number of sexual partners. "We think primary care physicians can be important in preventing HIV infection," says Sandy Kerr, a CDC public health analyst. "They are missing some opportunities to assess the risks of some of their patients." Other CDC statistics support Kerr's statement. In 1991, 55 percent of American adults who reported being tested for HIV had their most recent test conducted in a physician's office or at a hospital. "Recall Announcement Sends Copely Pharmaceutical Shares Plunging" Knight-Ridder/Tribune Business News (01/07/94) Following the discovery that its asthma inhalant was contaminated with bacteria, Copely Pharmaceuticals Inc. recalled the product. Company officials said that while the bacteria would not affect most patients, it could be potentially hazardous to those who are immunocompromised due to AIDS, cystic fibrosis, chronic lung disease, or chemotherapy. "Looking Candidly at AIDS Prevention" Chicago Tribune (01/06/94) P. 1-10 Public health officials and educators in the battle against AIDS have come to accept that, despite the epidemic, young people experiment with sex more than ever. Consequently, two-thirds of Americans infected with sexually transmitted diseases are under the age of 25. Unfortunately, the government's response to the epidemic among the young has been simplistic and ineffective. Thus, say the editors of the Chicago Tribune, the White House's frank radio and television advertisements promoting the use of latex condoms to prevent AIDS are a welcome and refreshing step toward becoming more direct about the issue. Some viewers may find the images portrayed in the ads offensive, and argue for less graphic messages aimed primarily at abstinence. But the Tribune editors point to the Reagan and Bush administrations, which promoted abstinence until blue in the face, but to no avail. While the Clinton administration agrees that abstinence is still the best way to prevent AIDS, officials wanted to try a more realistic approach--one that would capture everyone's attention. Some will cry that the nearly $1 million price tag on the ads is a waste of taxpayer dollars, and that the ads won't prevent AIDS. True, concedes the Tribune, but if the spots appeal to America's youth and persuade them to modify their behavior, and maybe say a few lives, the ads are well worth the investment. "Tularik and Merck to Collaborate on Viral Gene Regulation" Business Wire (01/06/94) South San Francisco--Tularik Inc. has formed a collaboration with Merck & Co. Inc. for the joint discovery and development of small molecule therapeutics which could prove useful in blocking viral transcription--a critical early step for virus replication. The two companies will use their collaboration to target herpes, human papilloma virus (HPV), and HIV, as well as some conditions associated with HIV, such as cytomegalovirus (CMV), Epstein Barr Virus (EBV), and Respiratory Syncytial Virus (RSV). Under the deal, Merck retains rights to any products developed to treat herpes, HPV, or HIV and options to products developed to treat CMV, RSV, or EBV. Both companies will contribute chemical and natural product libraries for drug screening. "Improper Infection-Control Practices During Employee Vaccination Programs--District of Columbia and Pennsylvania, 1993" Morbidity and Mortality Weekly Report (12/24/93) Vol. 42, No. 50, P. 969 Potential transmission of blood-borne pathogens, like HIV, through the improper use of needles and syringes or contamination of multidose medication vials poses a health threat to patients. Since September 1993, the Centers for Disease Control has been notified of improper infection-control practices in two cities that could potentially have exposed vaccine recipients to infection. In Washington, D.C., a physician administering flu shots to employees reused needles to inoculate more than one patient. And in Pennsylvania city, a physician dispensing flu and pneumococcal vaccines to employees used the same needle and syringe used to administer a flu vaccine to aspirate pneumococcal vaccine from a multidose vial of that vaccine and inoculate the same worker. Although a new needle and syringe were used for each patient, the doctor repeatedly punctured the multidose vials of pneumococcal vaccine with used needles. The CDC warns that improper handling of these instruments could result in transmission of the AIDS virus. For example, bacteria can survive in and have been transmitted to patients through contaminated multidose vials and syringes. Nosocomial patient-to-patient HIV transmission has also occurred through inadequate sterilization of needles and syringes and the inadvertent use of them between patients. Finally, in laboratory simulations of improper use, syringes and multidose vials became contaminated with viruses. The CDC recommends that, to avoid the risk of transmission, a needle used to inoculate a patient should be considered contaminated, and not used on another patient. All needles should be sterile, and those designed for single use should be discarded. Reusable needles and syringes should be cleaned and then sterilized by standard heat-based methods between uses. Finally, used needles should never be recapped using both hands or in any way that involves directing the point toward any part of the body. "A New Goal: Preventing Disease, Not Infection" Science (12/17/93) Vol. 262, No.5141, P. 1820 (Cohen, Jon) Since HIV was first isolated, researchers have been seeking a vaccine that could block infection completely, producing the desired effect of "sterilizing immunity." New studies with simians, combined with dispirited results from old ones, are causing scientists to reconsider the all-or-nothing strategy of sterilizing immunity. The reason for the shift in thinking stems from new studies which suggest that the immune system actually has the ability to contain infection with the AIDS virus. If the immune system does, in fact, have this mechanism, even a vaccine that does not offer sterilizing immunity may be able to delay or prevent disease. In response to this new data, scientists are switching the focus of research to prevention of symptoms. While the medical establishment is substantially divided on the issue, it is being taken seriously as a hallmark of a successful vaccine. Some have abandoned the all-or-nothing approach altogether. Says Alan Schultz at the Division of AIDS of the National Institute of Allergy and Infectious Diseases, "If sterilizing immunity is the way a vaccine is going to work, we should put all our money into condom distribution." The new efforts in the search for an AIDS vaccine may be gaining popularity because of their capacity to lower viral load--or the amount of virus actually in the blood. Edward Hoover, a pathologist at Colorado State University, sums up the idea behind reduction of viral load: "If one can heighten the immune response enough, it may be a realistic goal to try to achieve lifetime suppression of virus." "HIV Disease in Print: Psychosocial Interventions" Focus (12/93) Vol. 9, No. 1, P. 1 (Harrison, George) The purpose of "AIDS: A Complete Guide to Psychosocial Interventions," as stated by editor Helen Land, is to help service providers and educators to "comprehend the interplay of the physical, social, and psychological factors affecting clients and society as a whole so the appropriate services can be initiated." The book, which includes the diverse views of many groups affected by HIV, is divided into three sections. The first, dealing with service settings, addresses AIDS education, outpatient and inpatient services, home care, hospice settings, and the nature of service organizations. The second section offers information on the impact the AIDS virus has on marginalized groups such as gay men, drug addicts and alcoholics, minorities, women, and the homeless, as well as children and adolescents and caregivers. The final part of the book covers coping with HIV-related losses, legal and medical issues, and directions for social research. This book is successful in documenting the wide array of groups that are affected by HIV and AIDS, and describing how services need to be tailored for them. The paperback is 300 pages and is costs $24.95.