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But they said that data from elsewhere in China seemed far less complete. Noting that the team was "very
concerned about rumors we are hearing," WHO country representative for China Henk Bekedam said, "We do not
really know about Beijing & other provinces, and we have asked specifically about that."
The visiting WHO team met for over an hour with Vice Premier Wu Yi, who promised to look into the rumors of
unreported cases in Beijing, team members said. But they said that a possible explanation for the discrepancy was
that China was not reporting cases until they were finally & fully confirmed to be SARS, while some of the
patients in the wards might still officially be classified as suspected cases.
[ A reasonable reaction to persistent obscuring of poverty and
retrograde TB & malaria epidemics under AIDS rubric based on symptomatic field diagnosis in Africa ]
WHO officials say they have repeatedly pressed the Chinese about their data on the number of cases in Beijing
and have been repeatedly told that the data was completely reliable. Still, in private, team scientists have
expressed nagging concerns. When Chinese officials were insisting that there was no SARS in Beijing, scientists
wondered how a disease that could spread from Hong Kong to Canada, and from Vietnam to Singapore, could not
travel from Guangzhou to Beijing. There are more than 20 flights a day between the 2 cities.
Since then, Beijing has been filled with rumors about wards full of patients. The WHO team said today that it hoped
to be able to conduct its own investigation. During its weeklong stay in Guangdong Province, the team said it had
free access to hospitals, laboratories and patients, affording it great confidence in the data now coming daily from
there.
They said that in the last 2 months Guangdong had developed excellent systems for counting cases and greatly
enhanced precautions to prevent the spread of the disease, resulting in a sharp drop in the number of new cases.
"We have been commending the Guangdong experience as a model for China, maybe the rest of the world," Dr.
Bekedam said. No doctor has been infected there since 3.25.03 and there have been only 53 new cases this
month, giving scientists great hope that the spread of the disease can be controlled.
But the WHO team has not been granted such access in Beijing. "We were given an open book in Guangdong, and
hope to get the same for our week here," Dr. Bekedam said. An unresolved question is whether it is possible to
acquire SARS in Beijing: the Chinese health ministry says that all cases in Beijing were acquired elsewhere. Dr.
Jiang confirmed that of the patients in the military system, "most of them are people from Beijing who traveled,
especially to Guangdong."
In Hong Kong, SARS continued to spread, infecting 42 more people and killing 3, incl an American. Malaysia
became the first country to ban tourists from Hong Kong & mainland China for health reasons. A Hong Kong
Hospital Authority spokeswoman said tonight that a 51-year-old American man had been brought across the border
from Shenzhen in mainland China. He arrived unconscious at a Hong Kong hospital and was declared dead half an
hour later. The man's 6-year-old son was also hospitalized, and was in stable condition.The dead man's family
name was Salisbury, the spokeswoman said. AP reported that his first name was James and that he had been an
English instructor at a polytechnic institute on the mainland.
The 2 other SARS patients who died today were an 86-year-old woman and a 35-year-old man. Both had other
health problems, said hospital authority sr exec. manager Dr. Liu Shao-haei.
Malaysia today temporarily halted the issuance of visas to tourists from mainland China and suspended its previous
policy of allowing Hong Kong residents to enter without a visa for up to 30 days. Malaysia said that people traveling
on business trips, or for their govts, would still be allowed in from both places.
Hong Kong govt strongly criticized the measure as unnecessary. Thailand is already requiring arrivals from SARS-
affected countries to wear face masks. Also, S.African health officials today gave details of what they called Africa's
first "probable" case of the disease. The patient, officials said, was a 62-year-old man who had recently visited
Hong Kong, where the disease is most prevalent. He was admitted to Pretoria Hospital on Monday suffering from
respiratory problems. Medical tests have so far come back negative for SARS, officials said. But the results were
not conclusive, and officials said they were awaiting more results next week.
Dr. Willi Seiling, who is treating the patient at Pretoria East Hospital, said the man was in critical condition, but
progressing well. "I am happy to say that the patient is doing much better than he was when he was admitted," Dr.
Seiling said. Richard Friedland, a senior official at Network Healthcare Holdings, which runs the hospital, said the
patient was known to have had contact with 17 people, including 8 family members. All had tested negative for
SARS.
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US develops lethal new viruses 10.29.03 Debora MacKenzie New Scientist
Geneva A scientist funded by U.S. govt has deliberately created an extremely deadly form of
mousepox, a relative of the smallpox virus, through genetic engineering. The new virus kills all mice even if they
have been given antiviral drugs as well as a vaccine that would normally protect them. The work has not stopped
there. The cowpox virus, which infects a range of animals including humans, has been genetically altered in a
similar way.
Vaccines are currently our main defence against smallpox & its relatives, such as the monkeypox that reached
U.S. this year. Some researchers think the latest research is risky & unnecessary. "I have great concern about
doing this in a pox virus that can cross species," said Australian National Univ. in Canberra Ian Ramshaw on being told of Buller's work. Ramshaw was a
member of the team that accidentally
discovered how
to make mousepox more deadly (New Scientist 1.13.01). But the modified mousepox his team created was not as
deadly as Buller's.
Since then, Ramshaw told New Scientist, his team has also created more deadly forms of mousepox, and has
used the same method to engineer a more deadly rabbitpox virus. But this research revealed that the modified pox
viruses are not contagious, he says. That is good news in the sense that these viruses could not cause ecological
havoc by wiping out mouse or rabbit populations around the world if they escaped from a lab.
Ramshaw's team made its initial discovery while developing contraceptive vaccines for sterilising mice &
rabbits without killing them. The researchers modified the mousepox virus by adding a gene for a natural
immunosuppressant called IL-4, expecting this would boost antibody production.
Now Buller has engineered a mousepox strain that kills 100% of vaccinated mice, even when they were also
treated with the antiviral drug cidofovir. A monoclonal antibody that mops up IL-4 did save some, however. His
team "optimised" the virus by placing the IL-4 gene in a different part of the viral genome and adding a promoter
sequence to maximise production of the IL-4 protein, he told a biosecurity conference in Geneva last week.
Cowpox infects people, but Buller says the IL-4 protein is species-specific and would not affect the human immune
system. The experiments are being done at the second-highest level of biological containment. Ramshaw says
there is no reason to do the cowpox experiments, as his group's work on rabbits has already shown the method
works for other pox viruses.
Despite the concerns, work on lethal new pox viruses seems likely to continue in the U.S. When members of the
audience in Geneva questioned the need for such experiments, an American voice in the back boomed out: "Nine-
eleven". There were murmurs of agreement.
Killer virus
Melbourne
Australian researchers had no intention of producing a killer virus. They were
merely trying to make a mouse contraceptive vaccine for pest control. "But it's a good way to show how to alter
smallpox to make it more virulent," says Ken Alibek, former second-in-command of the civilian branch of the Soviet
germ-warfare program.
Defence experts are also worried about preserving the freedom to publish medical findings while trying to
stop the information falling into the wrong hands. According to former U.S. presidential adviser and Johns Hopkins
Univ. Ctr for Civilian Biodefense Studies dir. D. A. Henderson in Baltimore, what are effectively blueprints for
making microorganisms more harmful regularly appear in unclassified journals. "I can't for the life of me figure out
how we are going to deal with this," he says. | |
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Health experts predict that if 10 million Americans are vaccinated against smallpox, 20 will die outright from the
vaccine alone. What gets neglected is the 60-million-plus Americans with weakened immune systems who will be
put at risk by widespread vaccination. The national smallpox vaccination plan rolled out with a whimper last week. Part of the Bush administration's effort to stave off a bioterrorism attack, the vaccination plan was to begin with a strong start in CT by vaccinating 20 or more first-line medical responders who would then fan out and vaccinate thousands of other doctors, nurses, and emergency room personnel around the state. In coming weeks, other states will inoculate 500,000 first-line medical personnel in all major medical centers in the country against smallpox. Eventually 10 million more healthcare workers, firefighters, police, and emergency medical personnel will receive the vaccine.
In CT, only 4 people showed up to get the shot, and 3 of those were administrative personnel, the state
epidemiologist & 2 administrators at Univ. of Connecticut's Health Ctr. The numbers willing to volunteer for the
shots had been dwindling all week, as hospital associations, nursing unions, and other professional groups balked
at the risk of the smallpox vaccine itself and raised important questions about the true potential for a smallpox
terrorist attack.
The smallpox vaccine is made from live virus vaccinia or cow pox, cousin of smallpox. It can cause illness in a
significant number of vaccine recipients. Experts est. 1,000 out of every 1 million who receive the vaccine will
experience serious side effects, about 40 of those will be life-threatening illnesses, and 1 or 2 of those people will
die from it. So, of the 10 million expected to get the shots, 10,000 are expected to get sick, 400 will be threatened
with death, and 20 are expected to die outright from the vaccine alone.
Est. 60 million people in U.S. today living with weakened immune systems, most suffering from HIV/AIDS or
undergoing medical treatment that didn't exist 35 years ago when smallpox vaccinations were routine. People with
AIDS, cancer patients undergoing chemotherapy or radiation treatments, burn patients, and organ donor recipients
would all be put at an unacceptably high risk of death if their nurses & doctors are vaccinated for
smallpox.
Some officials caution smallpox attack is a real possibility. All it would take is one person to infect himself, travel to
a major metropolitan area's crowded public place to begin infecting people, they argue. Problems with this scenario
incl that smallpox has effectively been eradicated, with no new cases reported since 1977. Only known laboratory
stocks of the disease exist in highly quarantined labs in the U.S. & Russia.
Even in lone, kamikaze, infected terrorist scenario, the outbreak might not be as bad as Bush administration
advisors assume. Leading smallpox experts say now we have conditions less conducive to the massive outbreaks
of the past, when people lived in extended families in crowded rooms, with multiple family members sharing the
same bedrooms & beds. People wash their hands more and more people travel alone in cars and live in less
crowded conditions. We use strong disinfectants more often, and air & water is filtered and treated for
contaminants.
A realistic scenario of one person falling ill and then going through his or her day, even visiting a shopping mall
& going to work, shows that only one or maybe two other people would be infected with smallpox before the
sick person was sent to a hospital. In that kind of scenario, quarantine & area-specific vaccination would work
well to contain the disease.
Foege is definitely not a foe of vaccination in general. In the 1960s, when he worked for the CDC in Africa, Foege
developed a specific plan to vaccinate for smallpox that minimized the exposure to the vaccine and yet helped to
wipe out the disease in that part of the world. Univ. of Virginia Virginia Medical College internal medicine chair Richard Wenzel was faced with a crisis in the fall of 2001. During the height of the anthrax attacks, he received word that a patient with smallpox had been found and was being sent to his hospital. He quickly formulated a plan that would quarantine the patient and assign specific personnel to treat him who had been vaccinated as children. Wenzel located some smallpox vaccine for his hospital staff. |
In addition, Bill Foege is worried about public perception in the face of a real threat. If large numbers of people are
vaccinated now, when a threat doesn't exist, and many fall ill or die, then the public may be resistant to the vaccine
when a real outbreak occurs.
The speed with which the Bush administration is pushing the vaccination plan seems based on political necessity,
not public health concerns. There is currently a safer vaccine being developed & tested in Europe that doesn't
involve the use of live vaccinia. It will be about a year before that vaccine is made available here in the U.S., but the
Bush administration is pushing ahead with the older, more dangerous vaccine anyway.
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US & Vietnamese scientists are holding their first conference in Hanoi on effects wartime herbicide Agent
Orange. The conference, which opened on Sunday, will look at research showing that dioxin, a chemical used in
Agent Orange, is continuing to contaminate people 30 years after the US stopped spraying it over forests in south
& central Vietnam. US amb. in Vietnam Raymond Burghardt described the issue as the last significant ghost
of the war, but said that determining its impact so long afterwards would be extraordinarily complex. The project,
known as Operation Ranch Hand, was designed to poison the jungle cover used by communist forces. Studies
have shown that, 3 decades later, dangerous concentrations remain in some parts of Vietnam. Amb. Burghardt said the U.S. & Vietnam had dealt successfully with the issues of missing servicemen and the restoration of diplomatic & trade links. Determining the impact of Agent Orange would be equally difficult, he said. "Like much of our shared past, it is filled with controversy & emotion," he said. "There are few facts & findings that are universally agreed upon. Scientists have to struggle with the frustrating fog inherent in identifying increases in birth defects amid a pool of naturally occurring background genetic error." Vietnamese Vice Minister of Health Le Ngoc Trong said he hoped the US & Vietnam would share future research costs. Another ministry official said studies had shown "hot spots" where offspring of people sprayed displayed severe deformities.
Fish diet |
12.30.01 Helen Sewell BBC
'Startling' results
Export worry
6.30.02 Jim Kelly Sunday Times Dr Judith Ford, who performed the tests, concluded the men had been exposed to unidentified toxic agents. What was worse, she said, the cellular damage might have planted a genetic time bomb in their children. |
Several questions are expected to be raised.
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Dave Howe, member of Australia's early SAS counter-terrorist force, said soldiers were regularly exposed to toxic
chemicals in teargas during training at Swanbourne's Campbell Barracks. He believed the gas, still used in counter-
terrorism exercises, might be linked to worrying genetic disorders. Mr Howe, 45, wonders whether his wife's cancer
was caused by exposure to teargas residue on his clothes, and is worried about their daughter's health.
"CS gas is supposed to be disposed of at a toxic waste site," he said. "We had blokes passing out from breathing
the stuff and we'd clean up the stuff afterwards wearing only shorts. My wife used to wash my clothes when they
were covered in this stuff. In my day, counter terrorism was experimental and we had to try things to see what
worked. But we always thought that if we were injured or maimed, govt would look after us. Now we are asking for
help and they don't want to know."
Dr Ford said the high degree of genetic abnormalities detected by her tests should be a warning that something was seriously wrong which required more investigation. She said a medical review panel could assess the men's cases without a full scientific study. "The study performed on these men showed an extraordinarily high rate of chromosome abnormalities," she said, describing as reprehensible the dismissal of serious health concerns.
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