Subject: CDC AIDS Daily Summary for Date: Wed May 3 07:03:43 PDT 2000 (198 lines) From: National AIDS Info Clearinghouse Copyright 2000, Information, Inc., Bethesda, MD CDC HIV/STD/TB Prevention News Update Wednesday, May 3, 2000 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. HEADLINES PEER-REVIEWED JOURNALS "Preventable Childhood Tuberculosis in Alabama: Implications and Opportunity" GENERAL MEDIA "Health News & Notes: Virus Linked to Oral Cancer" "Across the USA: Maryland" "Drug Counseling Offered in US Prisons" "Science Briefs: Rabies AIDS Vaccine" "AIDS in Africa" "About 500,000 Rwandans Have HIV, Government Says" "Powderject Up on HIV Vaccine Progress" "Southern African Health Experts Discuss Regional Epidemic Diseases" "Inquiry Opens Into Irish Hemophilia Blood Scandal" *************************************************************** PEER-REVIEWED JOURNALS *************************************************************** "Preventable Childhood Tuberculosis in Alabama: Implications and Opportunity" Pediatrics Online (www.pediatrics.org) (04/00) Vol. 105, No. 4, P. 53; Kimerling, Michael E.; Barker, Jill T.; Bruce, Frank; et al. The number of childhood tuberculosis (TB) cases in Alabama has increased significantly in the past decade, while the adult rate has declined. A study of TB cases from 1983 to 1997 shows that non-White children have a higher disease rate than white children, and all preventable cases were found among African-American children. The nationwide trend towards fewer TB cases was not seen in Alabama, where lack of access to healthcare is a problem for poor and rural communities. From 1992 to 1997, there were 120 child cases of TB, and 25 were classified as preventable. During that time, there was 25 percent decline in childhood TB cases nationwide and a 4 percent decline among Alabama adults; however, the rate among children in the state increased 20 percent. The researchers point out that one problem in the state is the failure of the interview process to properly identify all children who had contact with index cases and give them preventive care. Adults with TB who fail to follow prescribed preventive therapy are also contributing to childhood cases. The authors note that "future progress toward realizing the goal of TB elimination will ultimately depend on the efficiency and effectiveness of the contact investigation process with careful targeting of high-risk groups." **************************************************************** GENERAL MEDIA **************************************************************** "Health News & Notes: Virus Linked to Oral Cancer" Atlanta Journal and Constitution (www.accessatlanta.com) (05/03/00) P. 5C Scientists from Johns Hopkins University have found that the virus that causes most cases of cervical cancer may also cause some oral cancer. The findings, which are reported in the Journal of the National Cancer Institute (2000;92:675-676,709-720), indicate that tumors associated with the human papillomavirus 16 strain could be less deadly than other cancers of the head and neck caused by smoking or alcohol. Each year, around 350,000 people worldwide are diagnosed with oral cancer, which is associated with smoking and heavy alcohol use. "Across the USA: Maryland" USA Today (www.usatoday.com) (05/03/00) P. 24A Officials in Maryland have agreed to conduct studies of hepatitis C infection among prison inmates. However, few agree on the best treatment for the infection, and some question whether taxpayers should pay for expensive treatment for inmates, when only about a fifth of people infected become seriously ill. "Drug Counseling Offered in US Prisons" Reuters Health Information Services (05/02/00) Nearly 40 percent of correctional facilities in the United States have substance abuse treatment to help prisoners and reduce crime after the prisoners are released, since many inmates reported using drugs or alcohol while committing their crimes. In a statement released by the Substance Abuse and Mental Health Services Administration (SAMHSA), Barry McCaffrey, head of the White House Office of National Drug Control Policy, said the United States' approach of primarily incarcerating drug offenders has been an unsuccessful social policy--one that is being replaced with a combination of treatment, testing, and law enforcement. A survey by SAMHSA and the Justice Department found that 50 percent to 80 percent of those arrested tested positive for drugs, compared to 6 percent of the general population who reported used drugs in the last month. SAMHSA has proposed using $10 million next year to give counseling and mental health services to inmates released into the community. "Science Briefs: Rabies AIDS Vaccine" Boston Globe (www.boston.com/globe) (05/02/00) P. C2; Reucroft, Stephen; Swain, John New research with the rabies virus may affect AIDS vaccine development. Scientists at Thomas Jefferson University in Philadelphia genetically modified a rabies virus and then got it to make HIV glycoprotein gp160 when it was injected into mice. The altered rabies virus does not kill the cells it infects, and the researchers hope that the animals' immune systems will react to the gp160 and generate a response against HIV. The findings were reported in a recent issue of the Proceedings of the National Academy of Sciences (2000;97:3544-3549). "AIDS in Africa" Washington Post (www.washingtonpost.com) (05/03/00) P. A22; Waldorf, Saral In a letter to the editor, Saral Waldorf, a former Peace Corps volunteer, discusses how he helped run an AIDS clinic in the Chitipa district of Malawi. Walforf notes that in 1995, many people in the country believed in a purported herbal AIDS cure called "mchape," which they also said protected people from becoming infected with HIV. Waldorf's office surveyed 115 mchape Chitipans and found that many people thought they were doomed by HIV and saw no reason to change risky behaviors that Westerners said put one at risk for infection. In trying to explain the popularity of mchape, Waldorf writes that "in the absence of a cure or even access to antiretroviral drugs to slow down the AIDS progress, even educated Malawians 'who should know better,' as one colleague put it, were grabbing at anything that promised hope." "About 500,000 Rwandans Have HIV, Government Says" Reuters (05/02/00) Over 6 percent of Rwandans--about 500,000 people--are infected with HIV, according to Health Minister Ezechias Rwabuhihi. Overwhelmed hospitals in the country often put two AIDS patients in one bed, Rwabuhihi said. Official data from Rwanda's AIDS control agency shows that 11.1 percent of Rwandans ages 12 to 49 are infected with HIV. Life expectancy in Rwanda has decreased significantly in Rwanda since the early 1980s and now stands at 42 years. "Powderject Up on HIV Vaccine Progress" Reuters (05/02/00); Hirschler, Ben Shares in PowderJect Pharmaceuticals jumped 9 percent to 485 pence after the company announced that pre-clinical trials of a vaccine designed to combat HIV indicated that the company's needle-free system may protect against infection. Two studies involving the simian immunodeficiency virus (SIV) showed that DNA vaccination using the PowderJect system of helium gas jets, as opposed to needles, was effective in producing a high cellular immune response. One study indicated an immune response equivalent to or greater than that produced by natural infection with SIV, while the other trial suggested protection against SIV infection transmitted by two separate routes. "Southern African Health Experts Discuss Regional Epidemic Diseases" Agence France Presse (05/02/00) Health experts from the Southern African Development Community have started a four-day conference on epidemic diseases in Africa. Chairman Ayanda Ntsaluba said the forum will focus on ways to combat AIDS, tuberculosis, and malaria, the primary cause of death among adults and children in the area. Malawi's deputy health minister, Phillip Bwanali, noted that "AIDS has become one of the dominating social, economic, and political issues of the past two decades." Bwanali said that limited funding from governments and reliance on donors have hampered national responses to the epidemic. "Inquiry Opens Into Irish Hemophilia Blood Scandal" Agence France Presse (05/02/00) The Irish Hemophiliac Society (IHS) has finally received a judicial inquiry into contaminated blood products that infected over 200 Irish hemophiliacs with HIV and hepatitis C and caused 74 deaths. The inquiry was slated to start Tuesday with personal testimony from 22 IHS members now living with HIV or hepatitis or whose family members have died. A 1997 tribunal condemned the Irish Blood Transfusion Service Board and the Department of Health for the infection of hundreds of women with hepatitis C via post-natal shots of a blood product. The IHS left that meeting because it did not deal directly with their situation, and it has taken more than two years to settle on terms of reference for the new inquiry.