EJAIB 13 (2003), 107-8 SARS: An Asian catastrophe which has challenged the relationships between people in society - My experience in Taiwan - Dena Hsin-Chen Hsin

EJAIB 13 (2003), 108-10 What have we experienced and learned from the outbreak of SARS in Beijing? - Baoqi Su

EJAIB 13 (2003), 142-143 SARS as an ethical test - James Dwyer

EJAIB 13 (2003), 208-9 SARS and Health Care Workers' Duty - Yujin Nagasawa

Criticism of the current UK vaccine for Whooping cough is in New Scientist (23 Oct, 1993), 7. On the pertusis vaccine see BMJ 307 (1993), 1430. A recent US National Academy of Sciences report has found that the risks of vaccination are generally very small, but it may be difficult to predict all the side effects and the exact risks due to deficient data; New Scientist (25 Sept, 1993), 9. Major changes are underway in the US vaccination program, JAMA 270 (1993), 1782+.

The July-August issue of World Health focused on the crisis of tuberculosis. Federal control of tuberculosis in the USA is discussed in JAMA 270 (1993), 1903-4. measles vaccination is discussed in BMJ 307 (1993), 1294-5.

The US Army is supporting research aiming to develop a potential vaccine against cholesterol; Science 262 (1993), 1974-5.

Papers with results suggesting some health care workers are at higher risk of not responding to hepatitis B vaccination are in JAMA 270 (1993),2931-4, 2935-9.

The Japanese problems (starting one year or more ago, as reported earlier) with measles-mumps-rubella vaccine (the Japanese produced version has many side effects) are discussed it Lancet 343 (1994), 105. In India, there is a dispute over origins of a leprosy vaccine involved in trials; Nature 367 (1994), 403. A report on the vaccination coverage of 2 year old children in the USA revealing major gaps is JAMA 271 (1994), 260-1.

A review of recent research on the immune system and prion disease is PNAS 91 (1994),, 429-32. There is weak evidence that some human disease, Cretzfeld-Jakob disease is linked to the bovine prion disease, Nature 367 (1994), 402. A gene involved in the resistance of tuberculosis to the drug isoniazid is discussed in Science 263 (1994), 172, 227-9. A series of papers and reviews on the immune system is in Cell 76 (1994), 207-332.

News from the development of vaccine producing plants is in Science 263 (1994), 1211. A general review of bacterial vaccine design isTIBTECH 11 (1993), 506-10; and of new vaccine technologies, JAMA 271 (1994), 929-31. A strategy to use intracellular immunization with cytosolic antibodies is reported in S. Biocca et al., "Intracellular immunization with cytosolic recombinant antibodies", Biotechnology 12 (1994), 396-9.

The results of malaria vaccine trials in Tanzania confirm that the Columbian vaccine appears to work; New Scientist (19 Feb, 1994), 7. A paper reporting the antigenic diversity of Plasmodium falciparum, which causes malaria, is Science 263 (1994), 961-3.

The finding of tuberculosis in a Peruvian mummy that died about 900 years ago, by finding TB DNA, shows that Columbus was not responsible for introducing TB to South America; Science 263 (1994), 1686-7; BMJ 308 (1994), 808. Meanwhile, TB continues to cause disease and deaths today, Biotechnology 12 (1994), 327; BMJ 308 (1994), 807; JAMA 271 (1994), 665-71, 708-9. The use of BCG vaccine is reported to reduce the risk of TB by 50%, JAMA 271 (1994), 698-702.

The US Childhood Immunization Initiative is discussed, along with the 1993 number of vaccine preventable diseases, in JAMA 271 (1994), 651-2. A survey of children of employees of Johnson and Johnson, who all have insurance, found immunization rates below the desired target; JAMA 271 (1994), 525.

A paper reporting successful vaccination of hepatitis C in chimpanzees is PNAS 91 (1994),, 1294-8. Trials of a recombinant hepatitis B vaccine are reported in JAMA 271 (1994), 859-61. A book review of Emerging Epidemics: A Thinking Person's Guide is Cell 76 (1994),599-601.

The logistics of the world-wide immunisation programmes are discussed in Scientific American (June 1995), 102-4. Six major vaccines are delivered to 110 million children in the world annually, and they cost more for transport and delivery (about ten times!) than to make. Efforts to make cheap, easy to deliver multiple vaccines are discussed. The dangers of donor shortages are discussed in Nature 368 (1994), 784.

A summary of the US Childhood Immunization Initiative is in JAMA 271 (1994), 1230. A call for the selective use of varicella vaccine following safe trial results in several countries is Lancet 343 (1994), 928-9. The relationship between social inequality and vaccination incentives are discussed in R. Reading et al., "Do interventions that improve immunisation uptake also reduce social inequalities in uptake?", BMJ 308 (1994), 1142-4.

A paper reporting the safe use of formalin-inactivated hepatitis A for short-term protection against hepatitis A in Thailand is JAMA 271 (1994), 1328-34, 1363-4. The trial was performed in 40119 children. A procedure for preparation of a potential malaria transmission blocking agent is in Biotechnology 12 (1994), 494-9, 461-2.

A review of the change in the idea of a vaccine to an agent that can also be used to treat a disease, not only prevent it, is in Science 264 (1994), 53-5. Vaccine therapies are currently under trial against herpes, leprosy, leishmaniasis, tuberculosis, and hepatitis B. An International Society for vaccines has been founded in the US, Science 264 (1994), 1528.

A conference report on multiple antibiotic-resistant pathogenic bacteria is in NEJM 330 (1994), 1229-30, 1247-51. A review of the problem is in Newsweek (28 March), 34-40; and a special issue of Science (15 April) 264: 327, 359-393 is devoted to the problems. Multidrug resistance in tumors is discussed in PNAS 91 (1994),, 3497-504. Reports on the scare over "flesh-eating bacteria", a strain of streptococcus bacteria that can usually be treated, but if not treated degrades flesh and can kill within 3 days, as seen in 11 deaths in UK this year, are Science 264 (1994), 1665; Time (6 June 1994), 49; Newsweek (20 June 1994), 40-1. A vaccine against the bacteria is reported in New Scientist (4 June 1994), 4.

Book reviews of Alan M. Kraut, Silent Travelers. Germs, Genes, and the Immigrant Menace, Basic Books, NY: 1994, 369pp., US$25, are in Science 264 (1994), 1615-6; Lancet 343 (1994), 1346-7. Other book reviews on disease are in NEJM 330 (1994), 1023-6; Lancet 343 (1994), 1212; see also a TV review of the discovery of the bacteria linked to ulcer is BMJ 308 (1994), 1378. Discussion of the mechanism of prion replication is Science 264 (1994), 528-31; and a review of inherited prion diseases is PNAS 91 (1994),, 4611-4; New Scientist (28 May 1994), 32-7. An editorial looking at human papillomavirus, which is related to warts, and whether the bovine form causes the increased frequency of warts in butchers is Lancet 343 (1994), 1114; Br. J. Dermatol. 130: 9-17. Reports from the cases of human plague in the USA, which indicate a growing role for domestic cats as vectors is JAMA 271 (1994), 1312. A description of post-polio syndrome is in Science 264 (1994), 909.

In the UK all students who have been offered places at medical school will now have to provide certificates to show that they have been immunised against hepatitis B, BMJ 308 (1994), 870-1,876, 1161; Lancet 343 (1994), 927-8. Dental schools will also need to be checked, and at the time of registration in 1996 the students must be shown not to be "infectious". There is some debate... There has also been a call for widespread hepatitis B vaccination in Europe, New Scientist (14 May 1994), 5.

The Ministry of Health and Welfare in Japan has made several changes to the vaccination procedures that are included under the Preventive Vaccination Law. Vaccines for polio and some other diseases will be offered until 7 and a half years of age instead of only until 4 years, and vaccine against Japanese encephalitits can be obtained at 6 months instead of only after 3 years; Yomiuri Shimbun (31 Aug 1994), 17. The outbreak of pertussis in immunised children is analysed in C.D.C. Christie et al., "The 1993 epidemic of pertussis in Cincinnati. Resurgence of disease in a highly immunized population of children", NEJM 331 (1994), 16-21.

The use of historical and serological screening can reduce the need for vaccination in M.J. Ferson et al., "Cost effectiveness of prevaccination screening of health care workers for immunity to measles, rubella and mumps", MJA 160 (1994), 478-82; see also L. Brenzel & P. Claquin, "Immunization programs and their costs", SSM 39 (1994), 527-36. Social inequalities in uptake of vaccines are debated in BMJ 309 (1994), 126-7. The General Accounting Office of the USA has given a bad review on the new "Vaccines for Children" US immunization program, Lancet 344 (1994), 324. Other papers on vaccination include: BMJ 309 (1994), 213-4, 223-5; Lancet 344 (1994), 144-5.

On the general merits of world-wide vaccination, MJA 160 (1994), 459-60; Science 264 (1994), 1864-7; Lancet 344 (1994), 174-5. Parasite disease is discussed in a number of papers in Science (24 June), 1857-77. Malaria vector control is discussed on pp. 1874-5; and on vaccination, Nature 370 (1994), 95-6. Hepatitis B vaccination for medical students is discussed in Lancet 343 (1994), 1571-3. A computer assisted method for vaccine risks analysis is available, Biotechnology 12 (1994), 826-7.

A new vaccine is reported in R.-P. Du et al., "A prototype recombinant vaccine against respiratory syncytial virus and parainfluenza virus type 3", Biotechnology 12 (1994), 813-8.

Efforts to combat drug resistant bacteria are discussed in GEN (July 1994), 1, 14; Science 265 (1994), 589-91; R.F. Breiman et al., "Emergence of drug-resistant pneumococcal infections in the United States", JAMA 271 (1994), 1831-5, 1875-6. The structure of influenza haemagglutinin is reported in Nature 371 (1994), 37-43. The use of an enzyme blocker against flu is reported in New Scientist (13 Aug 1994), 19. New antibiotics are researched in Science 265 (1994), 60. The use of antibody-targeted photolysis to kill bacteria is reported in Biotechnology 12 (1994), 703-6.

Research on prion diseases is discussed in PNAS 91 (1994),, 6418-22; Cell 77 (1994), 967-8; Nature 370 (1994), 295-7, 327-8. Mice that a devoid of PrP cannot propagate prion disease. A 3-d structure has been suggested, PNAS 91 (1994),, 7139-43. Warts in butchers are discussed in Lancet 343 (1994), 1511-2. On tuberculosis, Lancet 343 (1994), 1445-6 (Russia); 1482-5 (New York); 344: 277-8; NEJM 330 (1994), 1710-6, 1750-1. The use of a high-efficiency filters to protect workers against TB is dismissed as costly and ineffective in NEJM 331 (1994), 169-73. A commentary calling for preparation for emerging infections is Nature 370 (1994), 409-10.

A special issue of Science 265 (2 Sept), 1343, 1371-1404, includes numerous articles on vaccine development and policy. The development of needle-free vaccines is discussed in Science 265 (1994), 1522-4; and general recombinant techniques to make vaccines in Science 265 (1994), 1401-4; J. Pediatrics 125: 339-44. The engineering of poliovirus as a vaccine vector is reported in Science 265 (1994), 1448-51 (and on polio, Lancet 344 (1994), 630-1). A review of mouse models is Malo, D. & Skamene, E. "Genetic control of host resistance to infection", TIG 10 (1994), 365-70.

The outbreak of plague in India is discussed in Nature 371 (1994), 467, 543-4, 547; Time (3 Oct), 46, (10 Oct), 18-21; Science 266 (1994), 22-3. The lack of supply of antibiotics in the infected areas contributed to the spread, but generally it can be treated by antibiotics. Drug-resistant bacteria are discussed in Time (12 Sept), 40-7. The lethal streptococcus infections may be linked to resident viruses, Scientific American (Sept 1995), 26-7. The epidemiology of tuberculosis in the USA is in JAMA 272 (1994), 535-9. Lyme disease is reviewed in Scientific American (Sept 1995), 34-9.

Doubts on the efficiency of influenza vaccination in Japan are in Lancet 344 (1994), 408-9. A study finding cost benefits of influenza vaccination among elderly persons is Nichol, K.L. et al. "The efficacy and cost effectiveness of vaccination against influenza among elderly persons living in the community" NEJM 331 (1994), 778-84, 807-8; NEJM 331 (1994), 778-4. On asthma vaccines, Lancet 344 (1994), 456-8. Japanese B encephalitis vaccine safety is debated in MJA 160 (1994), 795-7. A recommendation that all non-immune travellers to developing countries be inoculated with hepatitis A vaccine is JAMA 272 (1994), 885-9. The new vaccines offer 95% protection for up to 10 years, whereas general immunoglobulin lasts for 3-5 months. Cancer vaccines are discussed in Scientific American (Sept 1995), 102.

Efforts to study the malarial parasites genome, in Tunisia, with French collaboration, are discussed in Nature 371 (1994), 732. On parasite diseases, Science 265 (1994), 1087-90; 1469-70. A discussion of prions and possible therapy is GEN (15 Sept 1994), 36; and on the safety of pituitary extracted growth hormone, Lancet 344 (1994), 612-3.

There has been ethical debate in the UK over the government campaign to immunise all children against measles, and many say a lack of full consent and information, BME 102 (Oct 1994), 3-5; Lancet 344: 174-5; BMJ 309 (1994), 1102-3, 1161-2; NEJM 331 (1994), 1397-1402. There are claims that it is experimental. The ethics of an influenza trial in the elderly are discussed in Govaert, T.M.E. et al. "The efficacy of influenza vaccination in elderly individuals. A randomized double-blind placebo-controlled trial", JAMA 272 (1994), 1661-5, 1700-1; see also FDA Consumer (Nov 1994), 16-9; Science 266: 234-6.

Finland's successful policy is reviewed in Peltola, H. et al. "The elimination of indigenous measles, mumps, and rubella from Finland by a 12 year, two-dose vaccination program", NEJM 331 (1994), 1397-402, 1446-7. The data on Moscow immunisation rates in children are in Lancet 344 (1994), 1366. In general on immunisation policy, AJPH 84 (1994), 1567-8; in the USA, Lancet 344 (1994), 1216.

AIDS vaccine trials are discussed below under AIDS. Positive results are found against cholera in Sanchez, J.L. et al. "Protective efficacy of oral whole-cell/recombinant b-subunit cholera vaccine in Peruvian military recruits", Lancet 344 (1994), 1273-6, 1241-2. Hepatitis B vaccines are discussed in Lancet 344 (1994), 961-2, 1292-3, 1438-9. The policies in Canadian medical schools are discussed in CMAJ 151 (1994), 957+.

The welcome success of the malaria vaccine is in Alonso, P.L. et al. "Randomised trial of efficacy of SPf66 vaccine against Plasmodium falciparum malaria in children in southern Tanzania", Lancet 344 (1994), 1175-81, 1172; also discussed in New Scientist (5 Nov 1994), 14-5; Science 266 (1994), 724; Lancet 344 (1994), 1172-3. Another method is reported in PNAS 91 (1994),, 9866-70. Malaria is in an outbreak in western India, BMJ 309 (1994), 183-4. On travel vaccinations, BMJ 309 (1994), 918-22; and antibiotics for diarrhoea, Lancet 344 (1994), 1520-1.

Mucosal vaccine progress is reviewed in GEN (15 Nov1994),1, 24, 32. These include live oral delivery vaccines, that avoids the passage through the gut which will degrade many. Fungal diseases are becoming more common, Science 266 (1994), 1632-4.

Production of vaccines to HIV and foot and mouth disease, that are in animal trials, from plant production in cowpea using cowpea virus, GEN (15 Nov1994),1, 26. A malaria vaccine made that way but also not yet confirmed, is Turpen, T.H. et al. "Malarial epitopes expressed on the surface of recombinant tobacco mosaic virus", Biotechnology 12 (1994), 53-8.

The vertical transmission of prion disease is debated in Human Reproduction 9: 1792-800.; and the appearance of small virus-like particles in the human disease is reported in Lancet 344 (1994), 923-4.

Plague in India is discussed in Nature 372 (1995), 119; BMJ 309 (1994), 893- 4, 897-8, 1369; JAMA 272 (1994), 1162, 1571; Lancet 344 (1994), 1033-5, 1298, 1359-60. Some Indians have claimed that it was not plague, and the lack of facilities for analysis of samples may have caused some confusion, but most experts still agree that it was plague, though not all of the 58 deaths and 5559 suspected cases may have been real. On tuberculosis, AJPH 84 (1994), 1729-31.

The UK measles vaccination campaign has stopped, following concerns that it was not really necessary, but the UK Dept. of Health considers that it prevented any measles outbreak; BME 104 (Jan 1995), 3-4; BMJ 310 (1995), 192-3. A call to restrict chickenpox vaccination to those at high risk is BMJ 310 (1995), 2-3. The ethics of an Italian pertussis vaccine trial are defended in JAMA 272 (1994), 1898-9.

Malaria vaccine research is discussed in Science 266 (1994), 1792; 267: 320-3. The first vaccine shown to work, developed by Columbian Manuel Patarroyo, called SPf66, is still controversial, despite some effectiveness in about a third of people tried (which globally could mean 100 million people don't get malaria.

A review of vaccines is Beardsley, T. "Better than a cure", Scientific American (Jan 1995), 88-95. A general view with a focus on Africa is Mulholland, K. "Measles and pertussis in developing countries with good vaccine coverage", Lancet 345 (1995), 305-7, 272. A review of progress towards the use of vaccinia virus as a vaccine vector is JAMA 272 (1994), 1810. On the future of vaccines in the USA, Lancet 345 (1995), 51.

A review is Prusiner, S.B. "The prion diseases", Scientific American (Jan 1995), 48-57. A claim that inadequate research is being done into the effects of prion disease in humans, that may have infected persons from eating beef which later suffered from mad cow disease is Dealler, S. "BSE and the ethics of not doing research", BME 104 (Jan 1995), 13-7. It presents some interesting calculations and projections. The UK Dept. of Health advice on handling instruments used in surgical operations with patients with Creutzfeldt-Jacob disease is debated in Lancet 345 (1995), 194. Results suggesting that Apolipoprotein E4 allele may not be a risk factor for this disease, unlike Lancet 342 (1993), 710-1; are in Lancet 345 (1995), 68-9.

An English report of the summary of the Russian National Committee on Bioethics report on mass vaccination is Yudin, B. "Vaccinoprophylaxis and human rights", IJB 5 (1994), 261.

The reliability of PCR for detection of active tuberculosis is questioned in NEJM 332 (1995), 128-9.

A review of current cancer vaccine efforts is JAMA 273 (1995), 528-30 (see also Gene Therapy section). WHO guidelines to prevent colorectal cancer are in Bulletin WHO 73: 7-10. A discussion of flu vaccines is New Scientist (18 Feb, 1995), 26-31. The method of eating proteins from various sources as specific methods to combat autoimmune disease, or oral tolerance therapy, is evaluated in New Scientist (21 Jan, 1995), 36-40. Some research suggests that inhaling the proteins is more effective than eating them.

A study in the UK found that one fifth of the parents who refused vaccination of children gave homeopathy as a reason, Simpson, N. et al. "Parental refusal to have children immunised: extent and reasons", BMJ 310 (1995), 227. A record linkage method to monitor for reactions to MMR vaccine is recommended in Farrington, P. et al. "A new method for active surveillance of adverse events from diptheria/tetanus/pertussis and measles/mumps/rubella vaccines", Lancet 345 (1995), 567-9.

There are world shortages of pneumococcal vaccine, and the shortage of intramuscularly administered immunoglobulin are expected to continue until a hepatitis A vaccine is licensed. Japanese-Chinese collaboration to eradicate polio is reported in Lancet 345 (1995), 455.

A study of which occupational groups in New Zealand should be vaccinated against hepatitis B found that health care workers, and caregivers for the developmentally disabled are two at risk groups, NZMJ 108: 82-4. On the general topic, BMJ 310 (1995), 400.

A review on the prospects for elimination of leprosy, which still has about 2.4 million affected persons, is Bulletin WHO 73: 1-6. An Indian government committee has accepted that it was pneumonic plague which killed 60 people in Surat last year, Science 267 (1995), 1268.

There are reports that a horse-killing virus, Borna disease virus, may transfer to humans and be linked to psychiatric disease, Nature Medicine 1 (1995), 232+; New Scientist (11 March, 1995), 16. PCR was used to show the virus was present in the brains of 6 affected persons (depression, obsessive compulsive disorder and panic disorder) but not in 10 normal persons. Another unknown virus is reported to do also transfer from horses but kills people, Science 268 (7 April 1995).

Another case of gene transfer, bacteria-bacteria, is blamed for an epidemic of cholera that was in Southern India; New Scientist (23 Feb 1995), 14; EMBO J. 14 (1995), 209+.

The threat of Ebola disease in Zaire is now lessening, but it took much attention and is an example of how diseases may suddenly infect large numbers of people, BMJ 310 (1995), 1344-5, 1353; Science 268 (1995), 19, 974-5; Time (22 May 1995), 50-1. The general movement of tropical diseases due to global warming is discussed in BMJ 310 (1995), 1027. Another emerging disease, is morbillivirus, Science 268 (1995), 94-7, 32. A report suggesting Borna disease virus may infect humans is Nature Medicine 1 (1995), 209-10, 232-6. Russia is reporting outbreaks of infectious diseases, especially diptheria and tuberculosis, BMJ 310 (1995), 821; Lancet 345 (1995), 715; Science 268 (1995), 1416-7.

Measles vaccination may have a slight risk of inflammatory bowel disease, though the survey used could have bias, Lancet 345 (1995), 1062-3, 1071+, 1362-4. The debate over the use of hepatitis B vaccine for at risk persons continues, although WHO recommended all infants in countries at moderate risk be vaccinated, Lancet 345 (1995), 1000-1, 1065, 1089-92; NEJM 332 (1995), 1092-3. A study finding low prevalence of hepatitis B markers and measles, mumps and rubella antibodies in Jewish refuges from Russia is JAMA 273 (1995), 954-6. The hepatitis A vaccine has been approved in the USA, JAMA 273 (1995), 906-7.

A chickenpox vaccine has been approved in the USA, which is 70-90% effective, BMJ 310 (1995), 824. The recommended schedule for infant vaccinations in the USA is in JAMA 273 (1995), 693; and the influenza vaccine has reached the year 2000 target coverage, JAMA 273 (1995), 765. A study finding that many Americans do not have immunity to tetanus is NEJM 332 (1995), 761-6, 812-3.

A UK survey of doctor's knowledge of notifiable, reportable and prescribed diseases is BMJ 310 (1995), 1299; and on methods to improve the notification rate of TB, BMJ 310 (1995), 974.

The low vaccination rate among some Australian groups is criticised in BMJ 310 (1995), 760; MJA 162 (1995), 471-5. Comments on the importance of the 8% of children in the UK who miss vaccines for measles is BMJ 310 (1995), 1367-8. Polio eradication is discussed in a series of papers in World Health (Jan/Feb 1995); also BMJ 310 (1995), 894; JAMA 273 (1995), 1407-9; Nature 375 (1995), 663. The theft of expired vaccines in Burma is causing concerns that the potentially dangerous vaccines may be used on the black market; Nature 375 (1995), 669.

The use of a genetically modified bacteria as a vaccine vector is reported in Shien, H. et al. "Recombinant Listeria monocytogenes as a live vaccine vehicle for the induction of protective anti-viral cell-mediated immunity", PNAS 92 (1995), 3987-91. On DNA vaccines, Biotechnology 13 (1995), 420. Conjugated Haemophilus influenzae vaccines for children are discussed in JAMA 273 (1995), 849-53.

Tuberculosis is discussed in BMJ 310 (1995), 954-5, 963-6, 967-9; NEJM 332 (1995), 1106-8; Lancet 345 (1995), 907-10; MJA 162 (1995), 285-6, 287-90; Science 267 (1995), 1763; NS (25 March, 1995), 4; and on airline flights, JAMA 273 (1995), 911-2. The issue of TB and illegal immigrants in the US is discussed in NEJM 332 (1995), 1071-6, 1094-8. Screening for TB and HIV in poor countries poses extra problems, including ethical ones, Lancet 345 (1995), 873. A review: De Cock, K.M. et al. "Preventive therapy for tuberculosis in HIV-infected persons: international recommendations, research, & practice", Lancet 345 (1995), 833-7.

Antitumour vaccines are discussed in Nature 375 (1995), 89; Nature Medicine 1 (May 1995). Infections of Helicobacter and cancer are discussed in Lancet 345 (1995), 874. A commentary looking at whether rheumatoid arthritis is caused by a virus is, Lancet 345 (1995), 1319-20. A review of a conference on leprosy is Lancet 345 (1995), 697-703; and a study finding no genetic link to leprosy in Brazil is AJHG 56 (1995), 1179-85. The law on leprosy in Japan is going to be changed to remove the need for isolation, Yomiuri Shimbun (13 May, 1995), 30. A review of hookworm infection is SA (June 1995), 68+.

A positive vaccine trial from Gambia is Aidoo, M. et al. "Identification of conserved antigenic components for a cytotoxic T lymphocyte-inducing vaccine against malaria", Lancet 345 (1995), 1003-7, 999. More on malaria in Marsh, K. et al. "Indicators of life-threatening malaria in African children", NEJM 332 (1995), 1399-404; and on protective guidelines, BMJ 310 (1995), 709-14. The WHO has signed a deal with the Columbian inventor of a malaria vaccine, Dr Manuel Pataroyo, Science 268 (1995), 791. A vaccine that works in mice against Leishmania is reported in Mougneau, E. et al. "Expression cloning of a protective Leishmania antigen", Science 268 (1995), 563+.

Methods to lower the costs of producing new vaccines include the use of a recombinant adjuvant, GEN (1 June 1995), 6-7. Polyclonal recombinant antibodies against tetanus are reported in Biotechnology 13 (1995), 683-5. The importance of protecting adolescent girls against tetanus is made in BMJ 311 (1995), 73-4. Good results have been obtained for trials of an acellular pertussis vaccine, JAMA 273 (1995), 1892-3; 274 (1995), 446-7; Lancet 346 (1995), 241; Science 269 (1995), 307; and it may be approved in the USA as soon as the end of 1995. There are other problems with child immunisation in the USA, Nature 376 (1995), 707-8. The possibilities for a cancer vaccine are reviewed in Lancet 345 (1995), 1384-5.

A criticism of why the UK government has not released the calculations which it said justified the measles vaccination campaign, is in BME 110 (1995), 1, 3-9. There are reportedly non-specific beneficial effects of measles immunisation, BMJ 311 (1995), 481-4; however, their are some risks and costs. The reforms in the Israeli child immunisation service are reported in JAMA 273 (1995), 1909-12.

Polio eradication is discussed in Nature 376 (1995), 630; Lancet 345 (1995), 1566, 1589; and the current vaccine is still recommended, JAMA 274 (1995), 12-3, 203. The number of cases of polio reported in 1993 was 109, though there was still only 80% vaccination coverage in developing countries.

The need to monitor outbreaks of new diseases is stressed again in MJA 162 (1995), 621. Research has found some genes are common between soft rot in plants and human tissue decay, Rahme, L.G. et al. "Common virulence factors for bacterial pathogenicity in plants and animals", Science 268 (1995), 1899-902, 1850.

Treatment of humans exposed to rabies in a New Hampshire, USA, incident is reported in JAMA 273 (1995), 293-4. The campaigns against tuberculosis in New York City appear to be working, NEJM 333 (1995), 229-33; but there are still problems in other countries, JAMA 274 (1995), 125-8. On global child health goals, JAMA 273 (1995), 103-5. Antigenic variation in malaria is reviewed in Cell 82 (1995), 1-4.

Research to make vaccines against cancer is discussed in Today's Life Science 7 (1995), 48-55. Epstein-Barr virus is linked to types of cancer, NEJM 333 (1995), 693-8, 724-6; and a new herpesvirus, Lancet 346 (1995), 782; NEJM 333 (1995), 797-9; and a review, Morris, J.D.H. et al. "Viral infection and cancer", Lancet 346 (1995), 754-8. A review of Helicobacter pylori, a peptic ulcer agent is JAMA 274 (1995), 1064-6. Certain bacterial Bacterioides and Bifidobacterium species were shown to be associated with risk of colon cancer in a study of Japanese, Caucasians and Africans, Moore, W.E.C. & L.H. "Intestinal floras of populations that have a high risk of colon cancer", AEM 61 (1995), 3202-7.

The funding cuts in the USA are also threatening the Centers for Disease Control, NEJM 333 (1995), 793-4. There is a shortage of funds to study Ebola virus, SA (Sept 1995), 34-5; which is reviewed in SA (Oct 1995), 56-64; and also a shortage of funds for early warning programs for disease outbreaks, Nature 377 (1995), 668. On Lyme disease, Science 270 (1995), 228-9; and the recent plague outbreak in India, Lancet 346 (1995), 765.

MacLeod, K., "Creation of first malaria vaccine raises troubling questions about "intellectual racism", CMAJ 153 (1995), 1319+. The malaria vaccine SPf66 was not shown to be effective in Gambian infants, Lancet 346 (1995), 462-7; Science 269 (1995), 1037. However, the WHO is still supporting it based on results of earlier trials. Inbreeding in some regions affected by malaria may hasten the transfer of drug-resistant parasites, Science 269 (1995), 755, 1670. Mosquito transmitted malaria was reported in 2 persons in New York City in 1993, Lancet 346 (1995), 729-31.

Genotyping of hepatitis D is reported in Lancet 346 (1995), 939-41; and of hepatitis C in NEJM 333 (1995), 800. The rise of hepatitis E is discussed in Lancet 346 (1995), 519-20. A Canadian program for universal hepatitis B vaccination at school is reported to be successful in JAMA 274 (1995), 1209-13; as is an infant program, JAMA 274 (1995), 1201-8, 1242-3, 1081.

Universal screening for tuberculosis in the USA is being considered, JAMA 274 (1995), 652-3. It is done annually in lung X-rays in Japan! TB remains the world's leading cause of death from infectious disease, with 2.7 million fatalities a year, Lancet 346 (1995), 948-9. Also on TB, NEJM 333 (1995), 519-20, 667-9; Lancet 346 (1995), 675-7, 790-1, 809-19.

A series of papers on global vaccination schemes are in SSM 41 (1995), 605-686. Influenza vaccine for healthy adults may not be cost effective, for those at low risk, but has usefulness that increases each year of vaccination, and it is recommended by some studies, NEJM 333 (1995), 889-93, 933-4; Lancet 346 (1995), 591-5; see also JAMA 274 (1995), 1005+. The cost effectiveness of chicken pox vaccine is claimed to save US$5 for every US$1 spent in the USA in SA (Oct 1995), 32-32D. On general vaccination for those over 50 years, JAMA 274 (1995), 789.

Drug resistance is discussed in NEJM 333 (1995), 481-6, 514-5; Lancet 346 (1995), 513-2.

The UK government is spending about 1 million pounds annually into research on Bovine Spongiform Encephalopathy (BSE), EBN 213 (1995), 2. A study using transgenic mice suggests that transfer of BSE to humans is unlikely, Collinge, J. et al. "Unaltered susceptibility to BSE in transgenic mice expressing human prion protein", Nature 378 (1995), 779-83, 759, 761-2. The other point of view is Diringer, H. "Proposed link between transmissible Spongiform encephalopathies of man and animals", Lancet 346 (1995), 1208-10. A range of views are in a series of commentaries in BMJ 311 (1995), 1415-21; and on the biology, NS (14 Oct 1995), 16-7; Trends in Microbiology 3 (1995), 141-7. A child who has contracted the human form of prion disease, Creutzfeldt-Jakob disease (CJD) suggests some possibility, Lancet 346 (1995), 1155. A local education authority in the UK as banned beef in over 1000 schools, Nature 378 (1995), 654. The resistance of microorganisms to disinfection in dental and medical devices is still a cause of concern, Nature Medicine 1 (1995), 956-7.

A review of the use of child records and privacy is Gostin, L.O. & Lazzarini, Z. "Childhood immunization registries. A national review of public health information systems and the protection of privacy", JAMA 274 (1995), 1793-9.

Influenza virus is discussed in Lancet 346 (1995), 1210-2; and emerging diseases in BMJ 311 (1995), 1378; Trends in Microbiology 3 (1995),64-9; NS (2 Dec 1995), 28-31. Opposition to an inactivated polio vaccine in the USA is delaying its incorporation into childhood vaccinations, JAMA 274 (1995), 1574-5. A summary of polio in South East Asia is JAMA 274 (1995), 1498-500; and world-wide, MJA 163 (1995), 399-400. A technique using heavy water has been developed as a method to keep vaccines cold in third world countries, NS (7 Oct 1995), 2. Vaccine policy in India is summarized in Biotechnology and Development Monitor 25 (Dec 1995), 5-7. The UK has defended its measles vaccination campaign reported last year, when 7 million children between 5-16 years old being vaccinated, BMJ 311 (1995), 1249. A study of vaccinia virus suggests that they have developed the ability to move along the actin filaments between cells, Nature 378 (1995), 636-8.

A short review of genetic engineering of infectious negative-strand RNA viruses as vaccines is Trends in Microbiology 3 (1995), 123-5. Cancer vaccination using live Listeria is reviewed in Trends in Microbiology 3 (1995), 451-3. A review of the use of Herpes simplex viruses as vaccines is Trends in Microbiology 3 (1995), 244-7. Genetic methods to combat malaria are reviewed in Nature Medicine 1 (1995), 745-7; and an altruistic vaccine that may help it passing on to others is being tried, NS (28 Oct 1995), 4.

An international panel of experts has suggested methods to eradicate tuberculosis, JAMA 274 (1995), 1255-7; also see Nature Medicine 1 (1995), 752.

It is commonly said that infectious diseases are no longer so important in the developed world, however the mortality again is increasing, Pinner RW et al. "Trends in infectious diseases mortality in the United States", JAMA 275 (1996), 189-93. Two papers further examining the genetic susceptibility to disease are: "Genetic susceptibility to Leishmania: IL-12 Responsiveness in TH1 Cell Development", "Genetic susceptibility to Leishmania major Infection in Interleukin-4-Deficient Mice", Science 271 (1996), 984-7, 987-990, see also 912. Letters on the disappointing results of the malaria vaccine trial in children are in Lancet 346 (1996), 1554-6; malaria remains a major disease, JAMA 275 (1996), 230-3.

A review of DNA vaccines is NEJM 334 (1996), 42-5. The use of a modified bacteria may improve the effectiveness of a TB vaccine, Science 271 (1996), 447; and on successful trials of acellular pertussis vaccines, NEJM 334 (1996), 341-8, 349-55, 391-2. The problems of keeping vaccines cold are discussed in SA (Feb 1996), 14-5. The success of measles vaccination campaigns in the Americas is reported in JAMA 275 (1996), 224-9; but there is still ethical debate over the measles campaign in the UK, BME 114 (1996), 1-2, 13-23. Also on immunization campaigns, AJPH 85 (1995), 1613.

A report from Gabon has found that 10 people who died from Ebola virus ate chimpanzee meat, and villagers have been advised to stay clear of animals behaving strangely, Nature 379 (1996), 671. On emerging microorganisms as a threat to people's health, JAMA 275 (1996), 176, 300-4, 315-7; Lancet 346 (1995), s27. A review of 25 years of antiviral therapy is in NEJM 333 (1995), 1704-5.

There continues to be discussion of the risks of eating beef in Britain, following some school's banning beef in school lunches, Lancet 347 (1996), 64-6, 195-6. Also on Creutzfeldt-Jakob disease, BMJ 312 (1996), 180-1. A paper arguing that cross-species prion disease is unlikely is Brandner, S et al. "Normal prion host protein necessary for scrapie-induced neurotoxicity", Nature 379 (1996), 339-43.

The cover page news in many countries has been the link between mad cow disease, bovine spongiform Encephalopathy, and the human form of prion disease, Creutzfeldt-Jakob disease (CJD). This has led to bans on the sale of British beef in the EU, and exports, and will lead to the controlled killing of older cattle. The ten new cases of CJD appear to be derived from the bovine form on circumstantial evidence, the new type is in young people; Will PG et al. "A new variant of Creutzfeldt-Jakob disease in the UK", Lancet 347 (1996), 921-5; NS (30 March 1996), 4-6. There have been criticisms of this blind haste to blame cattle, Nature 380 (1996), 271, 273-4, 370; Science 271 (1996), 1798; BME 116 (1996), 1; EBN 219 (1996), 5; BMJ 312 (1996), 790-3, 795, 843, 1037-9, 1056. France is also addressing the safety issues, NS (20 April 1996), 10. The European Minister's meeting at the end of May addressed methods to start reintroducing British beef into exports.

There is small potential for transmission of BSE via medicinal products, BMJ 312 (1996), 988-9. Mice lacking prion protein have altered circadian rhythms, Nature 379 (1996), 639-42; and those homozygous for the disrupted prion gene loss cerebellar Purkinje cell function, Nature 380 (1996), 528-31. A comparison to sheep scrapie is in NS (6 April), 5; (13 April 1996), 3, 4-5; and on other reports of CJD, Lancet 347 (1996), 482, 616-7, 889, 915-7, 945-8, 966-7. A call for development of a simple test to avert the mass cow slaughter is in NS (6 April 1996), 4.

A review is Clemens, J. et al. "Evaluating new vaccines for developing countries. Efficacy or effectiveness?", JAMA 275 (1996), 390-7. Oral vaccines using Lactococcus lactis, used in cheese-making are being developed, NS (20 April 1996), 23. The use of the Semliki Forest Virus genome for vaccine construction is reviewed in Molecular Biotechnology 5 (1996), 33+. A call for vaccine trials of recombinant proteins of cytomegalovirus is Trends in Microbiology 4 (1996), 34-7.

The ethical issues raised by side effects to hepatitis B vaccine in two children in the UK are debated in BME 115 (1996), 15-19. The cost effectiveness of HBV immunization are discussed in JAMA 275 (1996), 444, 907-9; and on the history of the vaccine, Science 271 (1996), 1213. Justification for revaccination against measles and rubella is made in BMJ 312 (1996), 589-90; and move to use inactivated poliovaccine in the USA has been made, JAMA 275 (1996), 827. Japan is using less influenza vaccinations since the mid-1980s, in contrast to the increase in the USA, Nature 380 (1996), 18.

A vaccine against leprosy made in India can half the recovery time of patients with leprosy, Nature Medicine 2 (1996), 262. A report on efforts to control rabies in Africa is BMJ 312 (1996), 785. A series of papers on infectious disease in Australia is MJA 164 (1996), 60-3. Tuberculosis killed 3 million people in 1995, and the number is growing, NS (3 Feb), 14; (30 March 1996), 8.

A report on the UK Gulf War veterans health has been issued in the UK, Lancet 347 (1996), 341. The US Presidential Advisory Committee on Gulf War Veteran's Illnesses has recommended the FDA provision to allow use of experimental drugs on combat soldiers in wartime be made permanent, Lancet 347 (1996), 532; BMJ 312 (1996), 1058.

There has been much discussion around the world of the ban on British beef, due to bovine spongiform encephalopathy (BSE) and possible links to the human prion disease, Creutzfeldt-Jakob disease (CJD), BMJ 312 (1996), 1117, 1313-4; Lancet 347 (1996), 1036, 1332-3, 1635; Nature 381 (1996), 15, 119. After a study of prion proteins in mammals, cows and humans share a couple of unique genetic changes in the region associated with development of disease, although overall cow and sheep prion are most related; Nature 380 (1996), 675. The varied response of the UK government to scientific advice is criticized in Nature 381 (1996), 351; and on the unscientific reactions and government bans of beef, Nature 381 (1996), 353-4. Scientists are calling for greater access to the emerging cases of CJD, Nature 381 (1996), 453. An analysis of an apparent UK dumping of animal feed after the ban on using it in the UK in 1989 is seen, Nature 381 (1996), 544-5. Swiss cattle are also being selectively killed, Lancet 347 (1996), 1035; NS (11 May 1996), 4. The debate over BSE in cows leading to CJD in humans has been dismissed in the US case, but there have been increased sensitivity to food components, Nature Biotechnology 14 (1996), 598-90. A preclinical test for prion diseases is reported in Nature 381 (1996), 563.

The UK MRC is facing negligence claims over CJD from growth hormone injections, Nature 381 (1996), 661.

A review of the growth in the number of vaccines is BMJ 312 (1996), 1177-8. It is expected that polio can be eradicated by the year 2000, BMJ 312 (1996), 1178-9; Lancet 347 (1996), 1250; though there are some political difficulties in reaching all children, NS (11 May 1996), 7. Designing a vaccine for tuberculosis is discussed in BMJ 312 (1996), 1495-6. Studies of host resistance genes can also be used to make vaccines, JAMA 275 (1996), 1464-5. Trends in infectious disease are sown in Science 272 (1996), 1269; EST 30 (1996), 183A; and on mechanisms, Science 272 (1996), 1261-3.

Seven dead miner's bodies in Norway are being exhumed in order to identify the cause of Spanish flu, a disease which killed 20 million people in 1918, NS (8 June 1996), 11. On the dangers of airline travel and infection, NEJM 334 (1996), 981-2. Interestingly, in some studies first class passengers suffer more food poisoning. However in the class divisions on land, more people in lower class get tuberculosis, for a book review see Science 272 (1996), 1116-7.

A possible explanation for Gulf War syndrome is that a combination of the anti-nerve gas pill, and two insecticides could have caused nerve damage, NS (27 April 1996), 4. There are safety concerns about Lariam, an anti-malaria drug, NS (8 June 1996), 14-5. The debate on whether chlamydia is linked to heart disease is assessed in NS (8 June 1996), 38-42.

Maternal transmission of bovine spongiform encephalopathy (BSE) has been shown at about 10% rate, Lancet 348 (1996), 393; Nature 381 (1996), 724; NS (10 August 1996), 10-11. A monkey has developed spontaneous prion disease, Lancet 348 (1996), 55; and also on the transmission, Lancet 348 (1996), 56-7, 326; Anderson, RM et al. "Transmission dynamics and epidemiology of BSE in British cattle", Nature 382 (1996), 779-88; 9, 381, 483, 574, 734-5, 743, 755-6; Science 273 (1996), 748; NS (3 August 1996), 3. Ethical guidance on ways to deal with disease outbreaks like BSE are in Nursing Ethics 3 (1996), 259-67. The rate of Creutzfeldt-Jakob disease in farmers is not significant, BMJ 313 (1996), 562; and on the human disease, Lancet 347 (1996), 1704. On blood donation, BMJ 313 (1996), 441. On the mechanism, JAMA 276 (1996), 438-40; Science 273 (1996), 184-9, 580, 622-6. A self-replicating 32 residue peptide has been made, Nature 382 (1996), 525-8.

DNA vaccination has worked against tuberculosis, Tascon, RE et al. "Vaccination against tuberculosis by DNA injection", Nature Medicine 2 (1996), 888-92; Huygen, K. et al. "Immunogenicity and protective efficacy of a tuberculosis DNA vaccine", Nature Medicine 2 (1996), 893-9, 857-9; NS (3 August 1996), 11. A cheap quick method to diagnosis tuberculosis has been reported by the company Biotec Diagnostic, in collaboration with London School of Hygiene and Medicine; EBN 228 (1996), 5. The test will be used in Africa in trials but is still more than the 50 cents per test target of WHO.

Many countries (USA, Germany, Italy, Sweden) are switching to acellular pertusis vaccines, Lancet 347 (1996), 1681. On 20 January 1996 the government of Indian vaccinated 93 million children against polio, the largest ever mass vaccination, and although there were 6179 cases of polio in 1995, it is still hoped the year 2000 will see the end of polio, JAMA 275 (1996), 1718. The SV40 virus which contaminated early batches of polio vaccine has been linked to cancer, NS (24 August 1996), 16. Efforts to develop a cocaine vaccine are being increased in the USA, Nature 382 (1996), 568. Thalassemia is discussed in Nature Medicine 2 (1996), 847-9.

A trial has found a Chinese herbal medicine, artemether is just as effective as quinine against cerebral malaria, NEJM 335 (1996), 69-75; NS (13 July 1996), 3, 4. The drug is injected into the muscles, and 6 80mg doses cost about 9 pounds.

On antibiotic resistance, Lancet 348 (1996), 400; also caused by animal use, NS (27 July 1996), 7. Drugs from an African plant family may be effective against cancer, NS (31 August 1996), 20.

The failure to fully explain the risks involved in a vaccine trial has resulted in a failure in a measles immunization program in children younger than 12 years, JAMA 276 (23 Oct. 1996). The introduction of Standards for pediatric immunization in the USA has increased coverage, JAMA 276 (1996), 626-30, also p.766. A study finding it would not be cost effective to introduce poliovirus into the routine childhood vaccination schedule in the USA is JAMA 276 (1996), 967-71. Economical use of rabies vaccine is discussed in Lancet 348 (1996), 614-5; and on a salmonella vaccine for chickens, NS (5 Oct. 1996), 10.

The global status of hepatitis B vaccination is summed up in Lancet 348 (1996), 696. 80 countries have introduced programs. Hepatitis B virus can survive in the body for decades, Nature Medicine 2 (1996), 1104-8. A campaign in Taiwan has protected most children under 10 from the disease, JAMA 276 (1996), 906-8. Vaccination in jail is discussed in NEJM 335 (1996), 885-6.

Hope for a vaccine from a mice study is Julia, V. et al. "Resistance to Leishmania major Induced by Tolerance to a Single Antigen", Science 274 (1996), 421-3. A genetic locus that controls the intensity of infection from the disease schistosomiasis (which kills 200,000 people a year) has been found, Marquet, S. et al. "Genetic localization of a locus controlling the intensity of infection by Schistosomia mansoni on chromosome 5q31-q33", Nature Genetics 14 (1996), 181-4.

The malaria vaccine using Spf66 has not had good efficacy, and in a Thai study was found to be 0% effective, Lancet 348 (1996), 695, 701-7; Science 273 (1996), 1652. A study has found a high incidence of malaria in alpha-thalassemic children, Nature 383 (1996), 480-1, 522-5; and on the future, Nature 383 (1996), 135. Genetically engineered mosquitoes may help fight infection, Nature Biotechnology 14 (1996), 820. A new collection on the subject is Camus, E. et al., eds., Vector-borne Pathogens: International Trade and Tropical Animal Disease, Annals N.Y. Academy Sciences 791 (1996), ISBN 0-89766-955-X.

Safer pertussis vaccines for adult use are discussed in Nature Biotechnology 14 (1996), 941; and a trial of a vaccine against Chlamydia trachomatis is Nature Medicine 2 (1996), 1116-21; NS (12 Oct. 1996), 18. A therapeutic cocaine vaccine has worked in rats, and may be close to human trials, Fox, BS. et al. "Efficacy of a therapeutic cocaine vaccine in rodent models", Nature Medicine 2 (1996), 1129-32, 1073.

Papers on bovine spongiform encephalopathy (BSE) include: 383 (1996), 201, 209, 463, 467, 565, 658, 666-7, 685-90; Lancet 348 (1996), 675. The number of declared cases by May 1996 was 158,866 in the UK; 211 in Switzerland, 125 in Eire, 18 in France, 30 in Portugal, Nature 382 (1996), 4-5. However it is thought that it is throughout Europe. UK scientists have claimed their access to the data has been limited. A case of CJD in a beef farmer, to add to the 3 cases in dairy farmers in the UK, is in Lancet 348 (1996), 610-1. Diagnosing Creutzfeldt-Jakob disease (CJD) is discussed in BMJ 313 (1996), 833-4, 836-7; NEJM 335 (1996), 963-5; Lancet 348 (1996), 955, 835, 846-9; JAMA 276 (1996), 938-9.

In the USA a study shows that 70% of infants get their first course of antibiotics during their first 200 days, Arch Fam Med. 5 (1996); 523-526. Researchers found that otitis media (middle-ear infection) was the most common reason for antibiotic treatment in infants. Amoxicillin was the antibiotic most often prescribed. Letters on use of antibiotics in cold are in Lancet 348 (1996), 754-5. On drug-resistance, Lancet 348 (1996), 928-31; and MRSA, Lancet 348 (1996), 836-7; NS (19 Oct. 1996), 32-5.
The European Union announced in November 1996 that it will spend $63.5 million on research into BSE, Creutzfeldt-Jakob disease in humans, and scrapie in sheep; Science 274 (1996), 1297-1298. It has spent much more to slaughter cattle infected with bovine spongiform encephalopathy--"mad cow disease"--and compensate farmers for their lost herds. The BSE controversy has led to more distrust of regulatory authorities, Nature 384 (1996), 201; SA (Dec 1996), 16, 18. Further on the European debate, Nature 383 (1996), 753; 384 (1996), 8-9. There is still debate over the extent of maternal transmission of BSE, Nature 384 (1996), 17; also see, Lancet 348 (1996), 1174; TIG 12 (1996), 467-71. Derivatives of amphotericin B have been found to delay death in hamsters infected with scrapies, NS (2 Nov 1996), 5; and on links between scrapie and BSE, NS (2 Nov 1996), 4; Lancet 348 (1996), 1157; BMJ 313 (1996), 1100. Marker methods are being improved, Lancet 348 (1996), 1230; Science 274 (1996), 721.

A commentary that vaccine usage patterns suggest that public health policies are necessary for vaccine acceptance is Nature Biotechnology 14 (1996), 1647. A study from Zimbabwe where traditional beliefs can inhibit health education is Pitts, M. et al. "Lay beliefs about diarrhoeal diseases: Their role in health education in a developing country", SSM 43 (1996), 1223-8. A review of Western medicine in India is Lancet 348 (1996), 1075-8. WHO and UNICEF have found vaccines very costly Nature Biotechnology 14 (1996), 1532. A call for the UK government to immunize all over 65 years old for influenza is BMJ 313 (1996), 1162. A letter on polio campaigns is Lancet 348 (1996), 1454.

The mechanism for the extreme sensitivity of Mycobacterium tuberculosis to the antituberculosis drug isoniazid is explained in Nature Biotechnology 14 (1996), 1557-61. Also on TB, JAMA 276 (1996), 1502-7,1512-3. On Teva's MS drug Nature Biotechnology 14 (1996), 1536. Malaria may be susceptible to a drug against its lactate dehydrogenase enzyme, and efforts are being made to test this idea, NS (16 Nov 1996), 17. Also on malaria, SA (Dec 1996), 52, 56; Lancet 348 (1996), 1196-201, 1377-9.

Research on cancer vaccines that are tailor made for each patient are being tested, NS (2 Nov 1996), 24. In general on vaccines, NS (2 Nov 1996), 26-9; and on the burden of disease, Science 273 (1996), 740-3. On Gulf War illness, Nature Biotechnology 14 (1996), 1645; NEJM 335 (1996), 1498-1513, 1525-6; Lancet 348 (1996), 1023. A review of McCormack, JB et al., Virus Hunters of the CDC (Atlanta: Turner 1996, 379pp., US$23, ISBN 1-57036-277-7) is in Lancet 348 (1996), 1433-4.

Letters calling for a ban on animal use of antibiotics for growth promotion because of the emergence of antibiotic resistance is in Lancet 348 (1996), 1454-6.

A review of the problems that drug-resistant bacteria pose to progress in reducing infectious disease is GEN (15 Jan 1997), 6, 29; NS (18 Jan, 1997), 24-7; SA (Feb 1997), 24-5; Lancet 348 (1998), 1703-4. Europe is considering banning use of avoparcin, an antibiotic used on farms, NS (21/28 Dec, 1996), 6. Resistant fungi are also a problem, JAMA 277 (1997), 5-6. On foodborne infections with E.coli, JAMA 277 (1997), 97-8; NS (21/28 Dec, 1996), 5; Nature 385 (1997), 474; BMJ 314 (1997), 241, 249.

A solution to the mystery of Gulf War syndrome appears to have been found. The name now given to the disease is MIRDS - mucocutaneous-intestinal-rheumatic desert syndrome, caused by a microorganism; NEJM 336 (1997), 259-61; JAMA 277 (1997), 215-22, 223-30, 231-7, 238-45; NS (18 Jan. 1997), 8; Nature 384 (1996), 604; 385 (1997), 185, 187; BMJ 314 (1997), 95, 168, 239-40; Probe V (No.9, 1997), 1, 4; Probe V (No.10, 1997), 1, 6.

On litigation on CJD, BME 123 (1996), 16-8. The general there have been changes in the way safety is monitored, Nature 385 (1997), 6-7. Some scientists predict a broader spread of mad cow disease, Time (27 Jan 1997), 48-9; Nature 385 (1997), 197-8, 200. The first German case has been confirmed and reported, Nature 385 (1997), 376. A prion test is being used to identify victims of CJD who caught it from BSE, NS (18 Jan. 1997), 10. Five French physicians are being charged with poisoning through infections of CJD in growth hormone preparations, Nature 385 (1997), 194; BMJ 314 (1997), 166.

Legal issues in controlling tuberculosis are reviewed in Weber, GS. "Unresolved issues in controlling the tuberculosis epidemic among the foreign-born in the United States", AJLM XXII (1996), 503-36. There has been a rise in the number of rabies cases in the USA, FDA Consumer (Nov 1996), 25-9. A review of the first 50 years of Centers for Disease Control and Prevention is in AJPH 86 (1996), 1705-8. On the WHO, NS (11 Jan. 1997), 12-3.

The sterile production of monkeys against malaria after administering interleukin-12 is reported in NatMed 3 (1997), 80-83. A sporozoite antigen based vaccine is being evaluated in tests, NEJM 336 (1997), 86-91, 128-9. Background on malaria is in a book review in Lancet 348 (1996), 1717. On the mechanism of resistance of African trypanosomes to cytotoxic human HDL Nature 385 (1997), 823-6.

A discussion of ethics is Preziosi, M.P. et al. "Practical experiences in obtaining informed consent for a vaccine trial in rural Africa", NEJM 336 (1997), 370-3.

On doctors and the plague outbreak in India in 1994, Monash Bioethics Review 16 (1) (1997),35-8. Many doctors also escaped from the city of Surat in the outbreak. A book review of Arrizabalaga, J. et al. The Great Pox: The French Disease in Renaissance Europe (Yale University Press 1997), 352pp., US$35, is in Nature 386 (1997), 343; and further book reviews on disease are Nature 386 (1997), 565; NS (22 March 1997), 46; JAMA 277 (1997), 437-8, 1007-8. Genetic analysis of the remains of virus in dead corpses has found some of the origins of the flu which killed 20 million people in 1918-1919, Taubenberger, JK. et al. "Initial genetic characterization of the 1918 "Spanish" influenza virus", Science 275 (1997), 1793-6, 1739. The Jan-Feb 1997 issue of World Health focuses on infectious diseases. On Zonzo and Ebola in Zaire, Lancet 349 (1997), 621.

A review is Jones, VE. & Mitchell, MS. "Therapeutic vaccines for melanoma: progress and problems", TIBTECH 14 (1996), 349-55. The most complex anticancer vaccine to date is being tested against prostrate cancer in New York, NS (1 March 1997), 20. DNA vaccines are being introduced into clinical trials for hepatitis B, HIV and influenza in GEN (1 April 1997), 6, 36.

On the link between Creutzfeld-Jakob disease (CJD) and BSE, Nature Biotechnology 15 (1997), 295. On BSE, CMAJ 156 (1997), 1043-6; Lancet 349 (1997), 636-41, 715-21. The number of possible CJD cases is still unsure, Lancet 349 (1997), 820, 847. The US FDA has imposed a ruminant-ruminant feeding ban, JAMA 277 (1997), 370. The Canadian Growth Hormone Advisory Committee is continuing its surveillance of patients who were treated with pituitary-derived growth hormone (GH) during childhood. To date, no cases of CJD related to the hormone have been reported in Canada, Japan or Australia. Since 1985, when CJD was reported in young adults who had received GH, more than 70 cases have been reported worldwide, France (40), the UK (15) and the US (15); CMAJ 156 (1997), 971. A review of the politics of mad cow disease in the UK, Newsweek (24 March 1997), 26-9.

Taiwan has a major foot and mouth disease epidemic that will cause slaughtering of 1.6 million of its 11 million pigs, Newsweek (7 April 1997), 32. This is similar to the 1.2 million cows to be killed in the UK out of 12 million. In Netherlands and Germany hundreds of thousands of pigs are being killed to stop swine fever, and a vaccine should be ready by 1998; NS (8 March 1997), 20. On the mechanism of scrapie, Nature 386 (1997), 137. Male hormones make animals less able to resist parasites, whereas estrogen enhances immunity, NS (15 March 1997), 19.

An endogenous retrovirus of pigs has been found to infect humans, raising concerns about xenografts (see Organ Transplant section), Nature Medicine 3 (1997), 282-6. A report from 1897 on infectious disease from domestic animals is JAMA 277 (1997), 361.

A series of reports on the need to control malaria is Nature 386 (1997), 535-8; NS (15 March 1997), 18; Science 275 (1997), 1485+. The parasites Plasmodium have been found to contain plant DNA in their apicoplast.

When an annual program of reviews was introduced in Georgia, USA, there was increased vaccination rates, JAMA 277 (1997), 631-5. The FDA has approved a second acellular pertussis vaccine for infants, JAMA 277 (1997), 783; and an influenza vaccine for infants, JAMA 277 (1997), 620-1. On the rational design of pertussis vaccine by genetic engineering, Nature Medicine 3 (1997), 374-6. Circumcised infants show higher pain response to routine vaccination than uncircumcised, Lancet 349 (1997), 599-603. A UK study found no increase in neurological damage with measles vaccination, Lancet 349 (1997), 730-1.

A discussion of E.coli O157 is in Lancet 349 (1997), 930; which examines how the horizontal transfer of verotoxin DNA may have occurred. Shedding of O157 normally takes 13-29 days, Lancet 349 (1997), 745-6. Following the outbreak in Japan a radish sprout farmer has claimed compensation from the government that issued a report that his farm was the source of the August 1996 outbreak, although there was no scientific evidence or signs of the bacteria, Nature 386 (1997), 211. It is also seen in the USA, AJPH 87 (1997), 176-80. On multidrug resistance, BMJ 314 (1997), 664-5.

On doctors and the plague outbreak in India in 1994, Monash Bioethics Review 16 (1) (1997),35-8. Many doctors also escaped from the city of Surat in the outbreak. A book review of Arrizabalaga, J. et al. The Great Pox: The French Disease in Renaissance Europe (Yale University Press 1997), 352pp., US$35, is in Nature 386 (1997), 343; and further book reviews on disease are Nature 386 (1997), 565; NS (22 March 1997), 46; JAMA 277 (1997), 437-8, 1007-8. Genetic analysis of the remains of virus in dead corpses has found some of the origins of the flu which killed 20 million people in 1918-1919, Taubenberger, JK. et al. "Initial genetic characterization of the 1918 "Spanish" influenza virus", Science 275 (1997), 1793-6, 1739. The Jan-Feb 1997 issue of World Health focuses on infectious diseases. On Zonzo and Ebola in Zaire, Lancet 349 (1997), 621.

A review is Jones, VE. & Mitchell, MS. "Therapeutic vaccines for melanoma: progress and problems", TIBTECH 14 (1996), 349-55. The most complex anticancer vaccine to date is being tested against prostrate cancer in New York, NS (1 March 1997), 20. DNA vaccines are being introduced into clinical trials for hepatitis B, HIV and influenza in GEN (1 April 1997), 6, 36.

On the link between Creutzfeld-Jakob disease (CJD) and BSE, Nature Biotechnology 15 (1997), 295. On BSE, CMAJ 156 (1997), 1043-6; Lancet 349 (1997), 636-41, 715-21. The number of possible CJD cases is still unsure, Lancet 349 (1997), 820, 847. The US FDA has imposed a ruminant-ruminant feeding ban, JAMA 277 (1997), 370. The Canadian Growth Hormone Advisory Committee is continuing its surveillance of patients who were treated with pituitary-derived growth hormone (GH) during childhood. To date, no cases of CJD related to the hormone have been reported in Canada, Japan or Australia. Since 1985, when CJD was reported in young adults who had received GH, more than 70 cases have been reported worldwide, France (40), the UK (15) and the US (15); CMAJ 156 (1997), 971. A review of the politics of mad cow disease in the UK, Newsweek (24 March 1997), 26-9.

Taiwan has a major foot and mouth disease epidemic that will cause slaughtering of 1.6 million of its 11 million pigs, Newsweek (7 April 1997), 32. This is similar to the 1.2 million cows to be killed in the UK out of 12 million. In Netherlands and Germany hundreds of thousands of pigs are being killed to stop swine fever, and a vaccine should be ready by 1998; NS (8 March 1997), 20. On the mechanism of scrapie, Nature 386 (1997), 137. Male hormones make animals less able to resist parasites, whereas estrogen enhances immunity, NS (15 March 1997), 19.

An endogenous retrovirus of pigs has been found to infect humans, raising concerns about xenografts (see Organ Transplant section), Nature Medicine 3 (1997), 282-6. A report from 1897 on infectious disease from domestic animals is JAMA 277 (1997), 361.

A series of reports on the need to control malaria is Nature 386 (1997), 535-8; NS (15 March 1997), 18; Science 275 (1997), 1485+. The parasites Plasmodium have been found to contain plant DNA in their apicoplast.

When an annual program of reviews was introduced in Georgia, USA, there was increased vaccination rates, JAMA 277 (1997), 631-5. The FDA has approved a second acellular pertussis vaccine for infants, JAMA 277 (1997), 783; and an influenza vaccine for infants, JAMA 277 (1997), 620-1. On the rational design of pertussis vaccine by genetic engineering, Nature Medicine 3 (1997), 374-6. Circumcised infants show higher pain response to routine vaccination than uncircumcised, Lancet 349 (1997), 599-603. A UK study found no increase in neurological damage with measles vaccination, Lancet 349 (1997), 730-1.

A discussion of E.coli O157 is in Lancet 349 (1997), 930; which examines how the horizontal transfer of verotoxin DNA may have occurred. Shedding of O157 normally takes 13-29 days, Lancet 349 (1997), 745-6. Following the outbreak in Japan a radish sprout farmer has claimed compensation from the government that issued a report that his farm was the source of the August 1996 outbreak, although there was no scientific evidence or signs of the bacteria, Nature 386 (1997), 211. It is also seen in the USA, AJPH 87 (1997), 176-80. On multidrug resistance, BMJ 314 (1997), 664-5.

Mutations associated with infections are reported in Summerfield, JA. et al. "Association of mutations in mannose binding protein gene with childhood infection in consecutive hospital series", BMJ 314 (1997), 1229-32. The virus adenovirus Ad-36 may be a cause of obesity in not only non-human animals, but also humans, Lancet 349 (1997), 1150. PCR can be used for diagnosis of viral infections of the nervous systems, Lancet 349 (1997), 1256. A probable role for bacteria role in chronic arthritis is suggested by PCR studies finding several strains in joint, Lancet 349 (1997), 1038, 1063+. A review of the use of molecular tests for diagnosis, GEN (15 April 1997), 6, 26. Acute arthritis was associated with adverse effects of rubella immuniza-tion in seronegative women, Lancet 349 (1997), 1277-81.

In highly endemic areas of Africa for malaria, methods to reduce parasite transmission operate, Lancet 349 (1997), 1650-4, 1636-7. A meeting report on new strategies for combating malaria is BMJ 314 (1997), 1707-8. On a field trial of an oral cholera vaccine in Vietnam, Lancet 349 (1997), 1253-4; and on oral vaccines, Lancet 349 (1997), 1676. Nasal vaccination is an alternative to influenza vaccines, Lancet 349 (1997), 1150.

The development of vaccines against E.coli urinary tract infections is expected following the results of a genetically modified vaccine, Science 276 (1997), 607+, 533. Some vaccination failures with Haemophilus influenzae type-b conjugate are reported in a UK study, Lancet 349 (1997), 1197-202, 1186. However a Gambian study found that it prevents most cases of pneumonia and meningitis, Lancet 349 (1997), 1191-7. The total synthesis of vaccine has also been achieved, Deshpande, PP. & Danishefsky SJ. "Total synthesis of the potential anticancer vaccine KH-1 adenocarcinoma antigen", Nature 387 (1997), 164-6. On Genzyme's research in cancer vaccines, GEN (1 June 1997), 1, 23, 38. A review of the was genomics is increasing understanding of disease is Strauss, EJ. & Falkow, S. "Microbial pathogenesis: genomics and beyond", Science 276 (1997), 707-12. A list of species and sequencing programs is on-line <http://www.tigr.org> Genentech scientists are developing one shot vaccine formulations using a polymer, polyactic-coglycolic acid, GEN (15 June 1997), 1, 12, 41.

The Japanese government has banned the use of dura mater grafts, 10 years after the FDA (see EJAIB May 1997), for fears that the transmit prion disease, Nature 387 (1997), 5. 43 cases of CJD may have been caused. The WHO had a meeting on evidence for human blood transfer of prions and the conclusion was that there is no known case, but people with CJD be excluded from being donors, Lancet 349 (1997), 1001. On the prion strains in CJD, NatMed 3 (1997), 521-5. Transmission between species may raise the virulence, Science 278 (4 July 1997). There is some evidence that mad cow disease is spreading in Europe but has been hidden, NS (3 May 1997), 14-5. There are doubts over whether gelatin can transmit prion disease, JAMA 277 (1997), 1659-60. The UK has announced that the spinal cord of sheep over one year of age must be removed from the carcasses like cows, and spleens banned for consumption, Nature 387 (1997), 749.

A US initiative on food safety has begun using increased inspections, new methods for detection and combating, JAMA 277 (1997), 1337, 1340-2. The global food markets increase the risks of disease, BMJ 314 (1997), 1645. The Scottish report on O157 has suggested education methods, hygiene, separation of raw and cooked food licenses, Lancet 349 (1997), 1073.

The emptying of airplane toilets at airports into the sewage systems is one way that microbes get transported around the world, NS (17 May 1997), 7. A study in the USA by the Centers for Disease Control found more than a hundred cases of disease caused by mysterious pathogens, NS (7 June 1997), 6. Researchers disagree with a recent WHO claim that the tuberculosis epidemic will soon be under control, NS (19 April 1997), 4; and on TB in Thailand, SSM 44 (1997), 1805-16. A book review on Yellow Fever is SA (May 1997), 112-5. Cockroaches have been linked to asthma, BMJ 314 (1997), 1437; NEJM 336 (1997), 1356-63.

Results in Taiwan show how liver cancer can be prevented by vaccination, Chang, MH. et al. "Universal hepatitis B vaccination in Taiwan and the incidence of hepatocellular carcinoma in children", NEJM 336 (1997), 1906-7; PNAS 94 (1997), 7121-5; BMJ 350 (1997), 7.

Two papers on the ethics of polio vaccination is AJPH 87 (1997), 913-5, 922-5. The rubella vaccine has been declared safe from chronic joint or nerve problems for use in a study in JAMA (19 August, 1997).

Policy issues for blood transfusion with risks of CJD are discussed in Health Law Review 6 (1997),12-7. In Japan the MHW ordered to removal of many vials of blood products that had been donated from persons with CJD, though most have been already given. However there has been no case of transmission reported in Japan. The ethical and legal problems of recipient notification are discussed in JLME 25 (1997), 34-41. On the risks of BSE, GEN 17(July 1997), 1, 4, 8, 37, 40; Cell 89 (1997), 495-8, 499-510; Int. J. Health Services 27 (1997), 243-6. There is a low chance BSE is mutating into new diseases across species, Lancet 350 (1997), 120, 187-8; Science 277 (1997), 94-8; NS (12 July 1997), 6; Raymond, GJ. et al. "Molecular assessment of the potential transmissibilities of BSE and scrapie to humans", Nature 388 (1997), 285-8, 228-9. On scrapie, PNAS 94 (1997), 4931-6. The Council of Europe conclusions on BSE are in IDHL 48 (1997), 85-6.

On genetic engineering of vaccines, 840, 882-6. A naked DNA vaccine is made in Kim, JJ. et al. Engineering of in vivo immune responses to DNA immunization via codelivery of costimulatory molecule genes, NatBio 15 (1997), 641-6, also p. 619; and on mucosal vaccines, NatBio 15 (1997), 622, and other methods, NatBio 15 (1997), 647-52, 653-57, 658-662. The insects or allergens may also be changed, Takai, T. et al. "Engineering of the major house dust mite allergen Der f 2 for allergen-specific immunotherapy", NatBio 15 (1997), 754-8. On the use of mutant p53 as a cancer vaccine, SA (August 1997), 36-7. On the role of viruses in cancer etiology, PNAS 94 (1997), 4237-8.

Having a more diverse social network gives a person increased resistance to colds, Cohen, S. et al. "Social ties and susceptibility to the common cold", JAMA 277 (1997), 1940-4; Proc. R. Soc. London B 264 (1997), 949-57. A US study found US$22.36 was saved per lost workday for a company investment of $2.58 per dollar invested in an influenza vaccine program, Am. J. Occup. Env. Med. (1997), 408+. On the dangers of E.coli, often involved in food poisoning, Lancet 349 (1997), 1847-8; Science Progress 80 (1997), 3-4. In Japan, 30% of E.coli O157 tested were resistant to at least one antibiotic, Asahi Evening News (22 July 1997), 1.

Malaria research is going to get increased funding, Science 277 (1997), 309; Nature 388 (1997), 211; and on techniques, Lancet 350 (1997), 192; BMJ 315 (1997), 96-7. Letters on the global burden of disease studies are in Lancet 350 (1997), 141-5; also, Nature 388 (1997), 410. On antibiotic resistance, Lancet 349 (1997), 1901-6; NS (26 July 1997), 25; BMJ 315 (1997), 57. There has been a outbreak of monkeypox virus in Congo, Science 277 (1997), 312-3. The flesh rotting disease Buruli is increasing in Ivory Coast. The importance of ecological monitoring for disease is stressed in JAMA 277 (1997), 189-91.

The success of vaccination programs in the US Childhood Immunization Initiative are reported in JAMA 278 (1997), 622-3. The prospects of vaccine development by the year 2000 and beyond are discussed in NatMed 3 (1997), 942, including prospects for removing measles within ten years. A call for a Human Germ Project to focus on all infectious diseases is made in Nature 389 (1997), 21-4; and a comparison of international assistance from different countries is Science 277 (1997), 760. An update on the WHO vaccine trial registry is Bulletin WHO 75 (1997), 295-305. A UNDP funded vaccine institute has started in Seoul, South Korea, Nature 388 (1997), 655. A discussion of the polio eradication efforts, Science 277 (1997), 779-80. Vaccines that generate cellular immunity are being developed, PNAS 94 (1997), 10496-8.

Early BCG vaccination in children does not seem to hasten the development of atopy, Lancet 350 (1997), 400-3. Rubella vaccine has passed a safety review for screening pregnant women, Lancet 350 (1997), 569.

The sandfly-borne parasite, Leishmaniansis tropica is the probable cause of Gulf War syndrome, Probe VI (3, 1997), 1, 4-5; Probe VI (4, 1997), 3-5; JAMA 278 (1997), 383-7. There are plans to revive development of sterile mosquitoes, Nature 389 (1997), 6; and also the genome of the malaria parasite will be sequenced, Nature 388 (1997), 699, 701; Science 277 (1997), 1437. The molecular basis of resistance and susceptibility to malaria is also being discovered, Lancet 350 (1997), 678-9; BMJ 315 (1997), 730-2. On insect control, NEJM 337 (1997), 785-6; virus hunting, NEJM 337 (1997), 577-8.

The question of control of patients and ethics is discussed in Oscherwitz, T. et al. "Detention of persistently nonadherent patients with tuberculosis", JAMA 278 (1997), 843-6. An assessment of world tuberculosis control is Lancet 350 (1997), 624-9.

There appears to be conclusive proof that BSE leads to CJD, Nature 389 (1997), 423, 437-8, 448-50, 498-501. A paper suggesting CJD may not be related to BSE is Coussens, SN. et al. "Sporadic Cretzfeldt-Jakob disease in the UK: analysis of epidemiological surveillance data for 1970-96", BMJ 315 (1997), 389-96. The UK government is planning to study more the links between BSE and CJD clusters, BMJ 315 (1997), 331. The age of onset is important for study of CJD, BMJ 315 (1997), 395-6. PrP-expressing tissue is required for transfer of scrapie infectivity from spleen to brain, Nature 389 (1997), 69-73; NS (13 Sept. 1997), 22-3. The discoverer of prions, Stanley Prusiner, received the 1997 Nobel Prize in medicine, Nature 389 (1997), 529. The European Commission may introduce a ban on drugs that have bovine, ovine or caprine ingredients, BMJ 315 (1997), 426. There are US complaints about some of the rules on BSE fears, Nature 388 (1997), 706. A book review on kuru is NatMed 3 (1997), 925.

The question of whether viruses may be involved in mental illness is discussed in SA (Oct. 1997), 38-9; Mestel, R. "Mind-altering bugs", NS (13 Sept. 1997), 42-5. Many drugs used for treatment are also anti-microbial. There is also a claim that a retrovirus may be involved in diabetes, NS (13 Sept. 1997), 6. Coronary artery disease risk can also be decreased in some cases with antibiotics, Lancet 350 (1997), 378.

A case of intentional food contamination in laboratory workers using Shigella dysenteriae is assessed in JAMA 278 (1997), 396-8; and in the community by a salad bar contamination with salmonella, JAMA 278 (1997), 389-95. The FDA is expected to acquire new powers over foods seen as public hazards, including fines, BMJ 315 (1997), 625. The USDA made the largest ever recall of beef on 15 August, in fears of E.coli O157, Lancet 350 (1997), 567. There is a call for a food agency in the UK, BMJ 315 (1997), 619-20. Hot weather also leads to more outbreaks on crowded farms, NS (23 Aug. 1997), 4. Hospital ventilation systems could also harbour many bacteria, NS (13 Sept. 1997), 4.

A vaccine for rotavirus is awaiting approval from FDA, GEN 17 (Dec 1997), 24, 38; Lancet 350 (1997), 1538-41; NatMed 3 (1997), 1324-5; BMJ 315 (1997), 1115; NEJM 336 (1997), 1228-9. The failure to implement mass vaccination against group A meningococcal meningitis in sub-Saharan Africa has lead to another epidemic, despite the vaccine being available, approved and cheap, Lancet 350 (1997), 880-2, 1565. On progress to global measles control, JAMA 278 (1997), 1396-7; and varicella, JAMA 278 (1997), 1495, 1520, 1529-30. US doctors who can give free vaccines do not refer people to public clinics so much, JAMA 278 (1997), 996-1000. Pheumococcal vaccine saves money when elderly people are vaccinated, JAMA 278 (1997), 1333-9.

A resistant strain of whopping cough is going across Europe despite vaccination, NS (11 Oct 1997), 5. In general on vaccine design, Science 278 (1997), 1711-4; also p. 19; Lancet 350 (1997), 1240-4; 1386-92; 1466-70, 1767-70; BMJ 315 (1997), 1595-8. A primer on Allergic and Immunologic diseases-4th edition is in JAMA 278 (10 Dec 1997), 1801-2026. On a trial of two acellular pertussis vaccines, Lancet 350 (1997), 1564-5, 69-77. Human herpes virus 6 is associated with multiple sclerosis, NatMed 3 (1997), 1394-7; BMJ 315 (1997), 1564; Science 278 (1997), 1710. Helicobacter pylori does not appear linked to ischemic heart disease mortality, BMJ 315 (1997), 1199-20.

The US pentagon admitted that unlicensed vaccine was given to 8000 soldiers in the Gulf War, the botulinum toxoid vaccine may be related to Gulf War syndrome, AP 23 Dec 1997. The UK Ministry of Defense was warned at the start of the war that the combination could have health effects, Nature 390 (1997), 3. A letter on the presence and sale of many unsafe expired vaccines in Asia is Nature 391 (1998), 222.

In December a new influenza strain was found in some chickens in Hong Kong, H5N1 virus influenza A, and a million chickens will killed in attempts to control it, while several people were infected and died; Time (12 Jan 1998), 15; Newsweek (12 Jan 1998), 12-7. On migration of people and new diseases, NEJM 336 (1997), 1700.

Guidance on the prevention of malaria for travelers is JAMA 278 (1997), 1767-71. On malaria vaccines, Lancet 350 (1997), 1696-701; and a new one, Gilbert, SC. et al. "A protein particle vaccine containing multiple malaria epitopes", NatBio 15 (1997), 1280-4; NatMed 3 (1997), 1315-6. A review of trials of mefloquine to prevent malaria is BMJ 315 (1997), 1412-6. Resistance mechanisms to chloroquine are reported in Cell 91 (1997), 593-603; Science 278 (1997), 223; see also Science 277 (1997), 1918-9; 278 (1998), 1393-4. Malaria has been acquired 13 times in 1994-1996 in Germany, NEJM 336 (1997), 1636; and South America has an epidemic likely after El Nino, NS (6 Dec 1997), 16. On leprosy after 2000, Lancet 350 (1997), 1717.

On recent trends in the falling number of BSE cases, Nature 389 (1997), 903. The UK banned the sale of beef from the bone, BMJ 315 (1997), 1560; NS (13 Dec 1997), 8; Ecologist 27 (1997), 182-3. The UK was also considering a ban on lamb on the bone, raising concerns from exporters of lamb like New Zealand. CJD disease from a Japanese woman who receive a cadaveric dural graft is reported in Lancet 350 (1997), 865-6; and a UK patient who donated eye tissue to 3 patients has been found to have had CJD, BMJ 315 (1997), 1485, 1553-4. The UK is studying whether a new form of vCJD may be transmitted by blood, Nature 390 (1997), 105, 541; CMAJ 157 (1997), 1367-70; Caulfield, T. et al. "Notifying patients exposed to blood products associated with Creutzfeldt-Jakob disease: integrating science, legal duties and ethical mandates", CMAJ 157 (1997), 1389-92. The nvCJD is caused by the same prion strain as BSE, BMJ 315 (1997), 831; JAMA 278 (1997), 1008-11; NEJM 336 (1997), 1821-8; Science 278 (1997), 31, 245-51. There may be prion-linked psychiatric disorders, Nature 390 (1997), 241; Lancet 350 (1997), 903-7, 908-10. B cells may propagate prions, Science 278 (1997), 2050; Nature 390 (1997), 662-3. The cellular prion protein binds copper in vitro, Nature 390 (1997), 684-7; and on prion disease, BMJ 315 (1997), 972; NEJM 336 (1997), 1016-7; Science 278 (1997), 214. Families of 14 young people who died from CJD after growth hormone treatment in the UK have received compensation, BMJ 315 (1997), 1401.

An age-appropriate sore throat score identified GAS infection in children and adults with sore throat better than usual care by family physicians, with significant reductions in unnecessary prescribing of antibiotics, McIsaac, WJ. et al. "A clinical score to reduce unnecessary antibiotic use in patients with sore throat", CMAJ 158 (1998), 75-83; 92-5. Patient's desires also influences what is given, BMJ 315 (1997), 1211-4, 1506-10. On economic perspectives on reducing resistance, SSM 46 (1998), 29-38. On concerns over growth in resistance, Hiramatsu, K. et al. "Dissemination in Japanese hospitals of strains of Staphylococcus aureus heterogeneously resistant to vanomycin", Lancet 350 (1997), 1670-3, 1644; JAMA 278 (1997), 901-4, 944-5, 2049-50; Lancet 350 (1997), 973-4; Nature 391 (1998), 291-5; Science 278 (1997), 575-6, 1731-2; NS (6 Dec 1997), 5. Household cleaners allow antibiotic resistance to develop, NS (20 Dec 1997), 7. There are variable mutation rates in commensal and pathogenic E. coli, Science 278 (1997), 1833-4.

A review is Levy, SB. "The challenge of antibiotic resistance", SA (March 1998), 46-53. On the medical consequences of agricultural uses of antibiotics, Science 279 (1998), 996-7. Having the genetic blueprints of bacteria may help fight drug-resistance, GEN 18 (15 Jan 1998), 9, 31. Acne treatment can also lead to resistance, Lancet 351 (1998), 422. On methods for long treatment, Guillemot, D. et al. "Low dosage and long treatment duration of b-lactam", JAMA 279 (1998), 365-70, 394-5.

India has approved a leprosy vaccine, BMJ 316 (1998), 414. On cross-immunity for leprosy and TB, AJPH 87 (1997), 1923-7. The genetic structure of the Chinese avian influenza from Hong Kong, H5N1 suggests it will probably not result in a pandemic, BMJ 316 (1998), 91, 325; Science 279 (1998), 324; Lancet 351 (1998), 115, 191; but we do not know when another pandemic will come, NS (31 Jan 1998), 18-9. On typhoid fever vaccines, BMJ 316 (1998), 110-6; and Arakawa, T. et al. "Efficacy of a food plant-based oral cholera toxin B subunit vaccine", NatBio 16 (1998), 292-8.

A genetic vaccine has been made against Ebola in a pig model, Xu, L. et al. "Immunization for Ebola virus infection", NatMed 4 (1998), 37-42, 16-7; Science 279 (1998), 983-4; Lancet 351 (1998), 117. A report on Australian vaccination practice is MJA 167 (1997), 296-7, 299-302; and international calls for vaccination are in NatMed 4 (1998), 1. A study of the impact of anti-vaccine movements on pertussis control is Lancet 351 (1998), 356-61. Communication of vaccine safety is discussed in AJPH 87 (1997), 1919-20. An estimate that 2010 will be the end for poliovirus immunization is Science 279 (1998), 788-9. After 30 years of follow-up the contamination of polioviruses with SV40 in 1955-1963 has not led to more cancer, JAMA 279 (1998), 292-5.

There is a conflict in the UK over the proposed killing of badgers to test whether they are involved in tuberculosis, Science 279 (1998), 817-8; NS (10 Jan 1998), 3, 10-1. On Lyme disease and ecology, Science 279 (1998), 984.

The NIH has opened the 3rd biosafety level 4 lab in the USA, without much local concern, NatMed 4 (1998), 136. A discussion of quarantine rules on animals in the UK and the protection from disease is NS (17 Jan 1998), 14. The food poisoning from E. coli in the UK may have come from Latin America, NS (10 Jan 1998), 12. Partnership between North and South in malaria control is called for in Science 279 (1998), 498-9; and on chloroquine resistance, NatMed 4 (1998), 23-4. The disease burden in sub-Saharan Africa is discussed in Lancet 351 (1998), 208-10. On the role of the media in health information a series of papers are in World Health (Nov. 1997), 1-29. Papers discussing the appointment of Gro Harlem Brundtland as the new WHO director are Lancet 351 (1998), 343, 381; Science 279 (1998), 166-9; and on globalisation of health, Lancet 351 (1998), 434-7.

A review of a UK inquiry on the role of science in BSE outbreak is NatMed 4 (1998), 135. A report on CJD from dura mater grafts in Japan is JAMA 279 (1998), 11-2. On prion disease, Science 279 (1998), 42-3; NS (24 Jan 1998), 24-8; Lancet 351 (1998), 419; NatGen 18 (1998), 94-5; Newsweek (23 Feb. 1998), 52-3. Aberrant synthesis at the ER leading to a transmembrane form of prion will result in neurodegenerative disease, Science 279 (1998), 827-34; also PNAS 95 (1998), 930-2.

Ethical issues are reviewed in Dare, T. "Mass immunization programmes: Some philosophical issues", Bioethics 12 (1998), 125-49; Lee, JW. et al. "Ethical dilemmas in polio eradication", AJPH 88 (1998), 130-1. A new bowel disease in children may be linked to MMR vaccine, and perhaps autism, Wakefield, AJ. et al. "Ileal-lymphoid-nodular hyperplasia, non-specific colitis and pervasive developmental disorder in children", Lancet 351 (1998), 637-41, 715-6; 905-6; BMJ 316 (1998), 724. An historical view is Gangarosa, EJ., et al. "Impact of the antivaccine movements on pertussis control: the untold story", Lancet 351 (1998), 356-61. The rate of recurrent collapse after pertussis vaccine may be about 1 in 2000 according to a Dutch study, BMJ 316 (1998), 876, 902-3.

The Japanese Council on Public health has recommended a comprehensive law on infectious diseases be made by April, 1999, covering all major diseases, NatMed 4 (1998), 261. On vaccine safety and risk communication, JAMA 279 (1998), 578; NatMed 4 (1998), 371. Contamination of early polio vaccines with SV40 may be linked to rare tumours, BMJ 316 (1998), 877.

A Christchurch, New Zealand study found good levels of immunization coverage there, NZMJ 110 (1998), 440-2. Universal vaccination against varicella is discussed in NEJM 337 (1998), 683-4; and on rotavirus vaccine in USA, JAMA 279 (1998), 489-90. Cholera vaccination in refugee settings is discussed in JAMA 279 (1998), 552-3. On measles eradication, BMJ 316 (1998), 765-7; AJHG 62 (1998), 215-20. Hepatitis A vaccine may be ready for general use, O&G 91 (1998), 468-71. Variations in the NRAMP1 gene are linked to susceptibility to tuberculosis, NEJM 337 (1998), 640-4; and in general on tuberculosis, NEJM 337 (1998), 677-8; NatBio 16 (1998), 359-63. One fifth of samples of unpasteurized milk in the UK were contaminated with bacteria, BMJ 316 (1998), 625-7.

A survey of attitudes to notification of individuals exposed to CJD in Alberta, Canada found 68% want to know but 54% said it may cause more harm than good, Health Law Review 6 (1998), 20-3. The UK public hearings on BSE suggest many errors occurred, Nature 392 (1998), 532-3. On the mechanism, Nature 392 (1998), 763-4; and detection of CJD, Otto, M. et al. "Diagnosis of Creutzfeldt-Jakob disease by measurement of S100 protein in serum: prospective case-control study", BMJ 316 (1998), 563-4; and possible vaccination, PNAS 95 (1998), 2520-5. UK blood products have been banned also in case they transmit CJD, BMJ 316 (1998), 726. On attitudes to disease and eradication of dracunculiasis in Africa, SSM 46 (1998), 799-810.

On new vaccine techniques, TIBTECH 15 (1997), 483-4; NEJM 337 (1998), 926-7; and a DNA vaccine, Nature 392 (1998), 408-11. Two new melanoma vaccines are reviewed in NatMed 4 (1998), 269-70, 328+. The mechanism of Ebola is being understood more, NatMed 4 (1998), 388-9; and a vaccine has protected guinea pigs, Science News (10 Jan 1998), 22-3. On emerging diseases, Science 279 (1998), 1629-30. The variety of the malarial parasite is important for its survival, Science 279 (1998), 1173-7; NatMed 4 (1998), 267-8; but a DNA vaccination trial is outlined in NatMed 4 (1998), 397-402; NS (28 Feb. 1998), 15. A leprosy vaccine has been approved in India, Lancet 351 (1998), 501. Mercury in Brazil from gold-mining may be related to reduced immunity to malaria, Science 279 (1998), 1850. Research on the Hong Kong bird flu is reviewed in JAMA 279 (1998), 643-4; Lancet 351 (1998), 467-71, 472-7. On the founding of an Asian Vaccine Institute in South Korea, Science 279 (1998), 2047.

Containment of antibiotic resistance is discussed in Science 279 (1998), 1153-4; JAMA 279 (1998), 579, 593-8, 623-4. The comparative genetics of resistance to viruses is discussed in AJHG 62 81998), 211-4.

The ethics of vaccination programs are discussed in Dare, T. "Mass Immunization programmes: Some philosophical issues", Bioethics 12 (1998), 125-49. The need for childhood vaccination is reemphasized in MJA 168 (1998), 476-7, 487-90; BMJ 316 (1998), 1569-72. A denial of any link between MMR vaccine and autism or inflammatory bowel disease is BMJ 316 (1998), 955, 1824; Lancet 351 (1998), 1327-8, 1355-8; NatMed 4 (1998), 478; NS (7 March 1998), 4; or Crohn's disease, BMJ 316 (1998), 1745-6. On influenza vaccines for children, NEJM 337 (1998), 1459-61. Children who have allergies can also be vaccinated, MJA 168 (1998), 491-4. Thousands of children in India may have been paralyzed due to polio in India because of failed immunization policies, BMJ 316 (1998), 1264.

General discussions on vaccine are in NatMed 4 (May 1998 supplement), 474-536. On economics of Haemophilus influenzae vaccine, Lancet 351 (1998), 1446-7, 1472-6; and of rotavirus immunization, JAMA 279 (1998), 1371-6. On idiotype vaccines, NatMed 4 (1998), 668-9. A vaccine for leprosy is being used in India, NatMed 4 (1998), 548-50. Approval of a vaccine against Lyme disease has been given in the USA, BMJ 316 (1998), 1695. A Cuban vaccine trial for meningitis B is being delayed by the US trade embargo against Cuba, Lancet 351 (1998), 1498. A mutated viral protein may soon enter trials as an asthma vaccine, NS (23 May 1997), 22.

The UK has pledged money for the WHO malaria initiative, Lancet 351 (1998), 1561; Science 280 (1998), 2067-8; and on malaria vaccines, NatMed 4 (1998), 479, 520-4. A paper on genetic modification of mosquito vectors is PNAS 95 (1998), 3349-50. On global disease eradication, JAMA 279 (1998), 897-9. There is an outbreak of Dengue fever in South East Asia, Time (18 May 1998), 51. A book review on cleanliness is NS (30 May 1997), 48-9.

Transgenic plants can be used to produce vaccines that lead to immunogenic responses, Ma, JKC. et al. "Characterization of a recombinant plant monoclonal secretory antibody and preventative immunotherapy in humans", NatMed 4 (1998), 601-6; Tacket, CO. et al. "Immunogenicity in humans of a recombinant bacterial antigen delivered in a transgenic potato", NatMed 4 (1998), 607-9; 502-3, 550-1; BMJ 316 (1998), 1336.

A review of a search for the mechanism of antibiotic resistance is Science 280 (1998), 27; NatMed 4 (1998), 545-6; NEJM 337 (1998), 1376-8. A review of an outbreak of multidrug resistant pneumonia in a nursing home is NEJM 337 (1998), 1861-8. On prescription of antibiotics, JAMA 279 (1998), 881-2. The WHO and US CDC have made a global monitoring system, Lancet 351 (1998), 1264. There is a need for urgent action, also discussed in UK, Lancet 351 (1998), 1298-9; BMJ 316 (1998), 1255-6, 1261. The first death in Japan from an antibiotic resistant bacteria was reported on 14 July, 1998. Some drug resistance can be traced to farm use of vanomycin, NS (21 March 1998), 13. A discussion of whether to treat viral infections or not is NatMed 4 (1998), 664-5. On drug-resistant tuberculosis, NEJM 337 (1998), 1689-90; and herpes, NatMed 4 (1998), 673-8.

A paper asking whether BSE is really a threat to human health is Environmental Health Perspectives 106 (1998), A134-8; BMJ 316 (1998), 1336. The risk of CJD in UK is no different to elsewhere, suggesting BSE may not be linked. There may be other genetic factors in CJD risk, Lancet 351 (1998), 1081-5, 1251. France, Ireland and Portugal have began to deplete leukocytes from donated blood to reduce CJD transmission chance, Lancet 351 (1998), 1112. Dura mater transplants are still allowed in the USA but new guidelines aim to reduce the risk of CJD, Lancet 351 (1998), 1258. The question of compensation for people who fear that they may develop CJD and those who did in the UK is discussed in BMJ 316 (1998), 1629, 1929; Lancet 351 (1998), 1640; and Australians will also receive compensation, Lancet 351 (1998), 1114. Also on BSE, BMJ 316 (1998), 1029, 1190; Nature 393 (1998), 321-2; NS (4 April 1998), 48; (13 June 1998), 4; and mechanism of prion disease, Cell 93 (1998), 203-14. A call to change the name CJD to Jakob's disease is made in Nature 393 (1998), 11.

The world campaign to eradicate polio may be slowed by the mistakes in India's vaccine program, NS (25 July 1998), 18-9. From 1999 poliovirus stock will enter biosafety standard 2 level as the stage towards eradication is made, NatMed 4 (1998), 873. A retrospective paper on smallpox eradication in Africa is in Bulletin WHO 76(1998), 219-32. DNA vaccination protects nonhuman primates against rabies, NatMed 4 (1998), 949-52. Studies finding that OspA vaccine against Lyme disease is effective are NEJM 339 (1998), 209-15, 216-22, 263-4; Lancet 352 (1998), 375. Soon we can expect to have anticancer vaccines being sold, SA (Sept. 1998), 40-1. Progress on identifying epitopes for use in salmonella vaccine development is being made, Science 281 (1998), 565-8. There are claims that hepatitis B vaccine is associated with a significant risk of infection from the disease, Science 281 (1998), 630-1. Discussion of vaccine adverse reactions is in NatMed 4 (1998), 746; BMJ 317 (1998), 159.

The molecule linked to malarial resistance against chloroquine is not like Na/H exchangers, Cell 94 (1998), 285-6. Research is developing new antiparasitic drugs, NatMed 4 (1998), 894-5. India has eradicated guineaworm, Lancet 352 (1998), 464. People exposed to waterways with Pfiesteria toxins may experience learning difficulties, Lancet 352 (1998), 532-9. Development of no-needle vaccines is discussed in GEN (August 1998), 19, 39, 56.

Book reviews of Klitzman, R. A Personal Account of Kuru, Cannibals, and Mad Cow Disease (Plenum Trade 1998, 330pp.) is NatMed 4 (1998), 858-9; Lancet 352 (1998), 75-6; Nature 394 (1998), 239-30; and of Ratzan, S. The Mad Cow Crisis. Health and the Public Good (Univ. College London Press 1998, 256pp.), in Lancet 352 (1998), 584; and of Powell, D. et al. Mad Cows and Mother's Milk. The Perils of Poor Risk Communication (McGill-Queens University Press 1997, 308pp.), Lancet 352 (1998), 583. Also on BSE, Lancet 352 (1998), 252-3, 584-5.

A discussion of ethics is Morabia, A. & Porta, M. "Ethics of ignorance: Lessons from the epidemiological assessment of the bovine spongiform encephalopathy ("Mad Cow Disease") epidemic", Perspectives in Biology & Medicine 41 (1998), 259-66. Blood supplies in the UK are being treated to reduce risk of prion disease, BMJ 317 (1998), 232. On the replication of yeast prions, Cell 94 (1998), 13-6.

Micro-bacteria less than 0.1 micrometres in size have been found which surround themselves with minerals and may be linked to many diseases, NS (11 July 1998), 11. On pneumonia treatment in Pakistan with co-trimoxazale, Lancet 352 (1998), 270-4. A review on politics and public health in TB control is AJPH 88 (1998), 1014-6, 1105-17. Tests are being conducted in the UK to check whether badgers are really the source of cattle TB, NS (22 August 1998), 13.

Japanese victims of discrimination against lepers have sued the government for 1.5 billion yen, Lancet 352 (1998), 631. Vaccine research on B-cell lymphoma is discussed in GEN (15 Oct. 1998), 22, 43. Giving vaccinations to starving people can be more effective if leptin is also given, and leptin may help the maintenance of the immune system, NS (29 August 1998), 4. There are also problems in refugee vaccinations, Lancet 352 (1998), 1229. A US CDC panel has recommended a global tuberculosis (TB) vaccine effort, NatMed 4 (1998), 1097. Also on TB, BMJ 317 (1998), 671-4. Skin immunization is possible by a cholera toxin, Nature 391 (1998), 851. A plant-based cholera toxin B subunit insulin fusion protein protects against the development of autoimmune diabetes, NatBio16 (1998), 934-8. On better mobilizing host defense and building better vaccines, NatBio16 (1998), 1025-31.

Malaria research funding is discussed in Nature 395 (1998), 417; Science 281 (1998), 1930. Seven antigens may be better for a vaccine trial, Lancet 352 (1998), 1163-4; Wang, R. et al. "Induction of antigen-specific cytotoxic T lymphocytes in humans by a malaria DNA vaccine", Science 282 (1998), 476-80. The mechanism of the 1918 flu pandemic is discussed in NatMed 4 (1998), 1122-3. The role of crowded pig farms in human disease is discussed in NS (10 Oct. 1998), 18-9. On hantaviruses, Lancet 352 (1998), 886. A book review of Hess, DJ. Can Bacteria Cause Cancer? (New York University Press 1998) is NatMed 4 (1998), 1197-8. A promising meningtis B vaccine has been found, BMJ 317 (1998), 770. Prenatal rubella screening and postpartum vaccination is discussed in CMAJ 159 (1998), 119-20.

There are numerous calls to act now on antibiotic resistance, NatMed 4 (1998), 985; NS (12 Sept. 1998), 13; JAMA 280 (1998), 1233+, 1270-1; and a series of papers in BMJ 317 (1998), 609-615, 645-71, 764; This is also from veterinary uses, BMJ 317 (1998), 610-1, 1029-30; Science 281 (1998), 1666-8; CMAJ 159 (1998), 1129-38. Streptogramins are one answer to resistance, Lancet 352 (1998), 591-2. Also on antibiotic resistance genes, NS (29 August 1998), 13. Single genes that bacteria need for survival have been discovered which will lead to new drugs, NS (5 Sept. 1998), 20. Methods for identification of essential bacterial genes are reported in NatBio16 (1998), 851-6, 821.

In July 1995 the Canadian Red Cross Society recalled blood products because of the hypothetical risk of transmission of CJD through those blood products. More than 80% of the respondents said they wanted to be notified and would want to be notified if there were another recall, CMAJ 159 (1998), 817-22. See also, King, SM. et al. "Notifying patients exposed to blood products associate with Creutzfeldt-Jakob disease: theoretical risk for real people", CMAJ 159 (1998), 771-4, 663.

Protein conformation tests can distinguish prion strain, NatMed 4 (1998), 1125-6, 1157-65. There are many difficulties in methods to estimate the number of people incubating variant CJD, Lancet 352 (1998), 1353-4. In fact some would say there may be as many problems as answers in screening, NS (5 Sept. 1998), 5; Nature 395 (1998), 6-7. This is also due to variability, CMAJ 159 (1998), 1117. The UK safe policy on avoiding blood plasma in blood products to lower prion risk is being used, Nature 392 (1998), 3; however there are still concerns on methods of patient transmission, Lancet 352 (1998), 795. However BSE could be also transmitted via sheep, if the symptoms are similar to scrapie and it is not realized, Lancet 352 (1998), 883; Nature 395 (1998), 1; BMJ 317 (1998), 700. There is prion immunoreactivity in the appendix before the clinical onset of CJD, Lancet 352 (1998), 703-4; BMJ 317 (1998), 617; Science 281 (1998), 1422-3. Portugal reported 60 new cases of BSE in the first half of 1998, third after UK and Ireland, Science 282 (1998), 227. On the inquiry into safety of beef, BMJ 317 (1998), 1031. The mechanism of neurodegeneration may involve chaperones and may be similar to Alzheimer's and Parkinson's disease, Nature 392 (1998), 23-4.

Methods for screening pathogens are discussed in Science 282 (1998), 219-221. Scientists have documented a case where a single pest, a protozoa, killed off snails in a protected breeding program making the species extinct, Science 281 (1998), 215. E.coli O157 cases may be associated with cattle, Lancet 352 (1998), 1005, 1207-12. Individual sensitivity to the plague may be related to a cell surface receptor, Toll-like receptor 2, Nature 395 (1998), 217-8. On Gulf War illness, JAMA 280 (1998), 1010-1.

African countries also are keeping up with attempts to eradicate polio by the year 2000, JAMA 280 (1998), 1980-1. A study has found that hepatitis B vaccine can be delivered at reasonable costs in US schools, AJPH 88 (1998), 1638-44. However, a French program is being halted because of fears MS can be triggered by the vaccine, NatMed 4 (1998), 1217. A study of ways for education of immunization is made in AJPH 88 (1998), 1821-6; also JAMA 280 (1998), 1482-3. A review of the risks of the 1954 Salk vaccine trials is BMJ 317 (1998), 1233-6. Influenza vaccination may be linked to Guillain-Barre Syndrome, NEJM 339 (1998), 1845-6. Bill Gates has donated a US$100 million fund for children's vaccines in developing countries, Science 282 (1998), 1971.

A plant produced vaccine is Zeitlan, L. et al. "A humanized monoclonal antibody produced in transgenic plants for immunoprotection of the vagina against genital herpes", NatBio 16 (1998), 1361-4. A synthesized live virus vaccine against tick-borne encephalitis has worked in mice, NatMed 4 (1998), 1357-8; NS (5 Dec. 1998), 6. Letters of recruiting volunteers for a typhoid vaccine are in JAMA 280 (1998), 1480-1. An anticancer vaccine using cells engineered to secrete granulocyte-macrophage colony-stimulating factor has generated antitumour immunity, PNAS 95 (1998), 13141-6. A DNA vaccine that may work against lymphoma and myeloma is reported in NatMed 4 (1998), 1281-8, 1239-40. However, some anticancer vaccines may not be selective enough, NS (7 Nov. 1998), 26. Naked DNA vaccines are being tested, NatBio 17 (1999), 1304-5. DNA vaccines are also being used for animals, NatBio 16 (1998), 1325-8. A nasal vaccine is being tested against bubonic plague, NS (5 Dec. 1998), 14.

Progress in treating influenza is discussed in JAMA 280 (1998), 1729-30; Lancet 352 (1998), 1877-81; SA (Jan 1999), 78-87. ApoE4 seems to also alter herpes virus entry into cells, NatMed 4 (1998), 1344. Efforts to reduce tuberculosis are discussed in JAMA 280 (1998), 1702-3; PNAS 95 (1998), 13352-4, 13881-6; Lancet 352 (1998), 1886-91; BMJ 317 (1998), 1220-3. A summary of the global burden of disease study is NatMed 4 (1998), 1241-3. A book review of Viruses, Plagues and History is NatMed 4 (1998), 1327-8. Treatment of nonuclear dyspepsia is related to presence of Helicobacter pylori, NEJM 339 (1998), 1869-74, 1875-81, 1928-30. Some E. coli strains can burrow deeply into urinary tissue escaping antibiotics and immune system, and repeating infections, BMJ 317 (1998), 1473. A vaccine against the E. coli strain O157 is being designed, Science 282 (1998), 1404. The possibility that Chlamydia pneumoniae is linked to Alzheimer's disease is discussed in Science News 154 (1998), 325.

On malaria research, NatMed 4 (1998), 1244-5, 1351-3, 1360-2; JAMA 280 (1998), 1978; BMJ 317 (1998), 1506-8. The sequence of chromosome 2 of the parasite Plasmodium falciparum has been published, Science 282 (1998), 1126-32. Italy has offered free therapy for rare diseases, those with less than 1 case per 2000 people, and has made a list of 400 eligible diseases, Lancet 352 (1998), 1997. Only one in five persons develops symptoms to Herpes virus, but companies are encouraging testing, NS (12 Dec. 1998), 24-5.

A paper on the epidemiology of Creutzfeldt-Jakob disease (CJD) in the UK is Proc. Roy. Soc. Lond. B. 265 (1998), 2443-52. A statement by the Royal Institute of Public Health and Hygiene and the Society of Public Health on the UK Inquiry on BSE is Public Health 112 (1998), 363-4. Prions are discussed in the Nobel Lecture of Stanley Prusiner in PNAS 95 (1998), 11030-1, 133363-83. There are questions why governments do not offer quick testing for BSE in beef, NS (14 Nov. 1998), 22-3. The origins of prion disease and CJD are reviewed in BMJ 317 (1998), 1688-92; p. 1273.

Papers on antibiotic microbial resistance are in Lancet 352 (1998), 1783; NatMed 4 (1998), 1343-4; Public Health 112 (1998), 415-7; FDA Consumer (Nov 1998), 23-25; BMJ 317 (1998), 1521. The question of whether toys and toothbrush and such common items bred resistant bacteria is discussed in SA (Nov 1998), 29. Mutating viruses are likely in chicken farms, NS (5 Dec. 1998), 24. New antimicrobials are being developed, NatBio 16 (1998), 1318.

The plant vaccine company Axis Genetics has entered into a collaborative agreement with Riche Vitamins for evaluating the oral efficiency of Epicoat vaccines, GEN (1 April 1999), 1, 40, 47. Monsanto is also developing vaccines in plants, GEN (15 Feb. 1999), 1, 8, 35. On the dangers of DNA vaccination, NatMed 5 (1999), 126. RNA may be used to make vaccines, SA (Feb. 1999), 42, 44.

There have been some promising trials of a recombinant multivalent malaria vaccine, PNAS 96 (1999), 1167-9, 1615-20; BMJ 318 (1999), 557; Lancet 353 (1999), 648; NS (20 Feb. 1999), 11. The vaccine targets the parasite at several stages of its life cycle. Human immunity to malaria is usually acquired only after 1-2 infections, NatMed 5 (1999), 272-3. On methods malaria escapes immune destruction, Nature 398 (1999), 562-3, 618+.

On polio eradication, JAMA 281 (1999), 221, 223. Development of a vaccine for Pseudomonas aeruginosa is reported in NatMed 5 (1999), 378-9; 392-8. Reports on surviving Ebola infection are reviewed in NatMed 5 (1999), 373-4. Influenza A and B can be prevented to significant degrees in health care professionals by vaccination, JAMA 281 (1999), 908-13. Hepatitis A vaccine can prevent hepatitis A in household contact, Lancet 353 (1999), 1136-9.

Letters on voucher incentives to improve US immunization rates are is JAMA 281 (1999), 702-3. State policies can improve rates but more is needed, AJPH 89 (1999), 164-70. The UN is ending the children's vaccine initiative, but will establish some other coordination if possible, Science 283 (1999), 1992-3. India has increased its funding for vaccines, Nature 398 (1999), 4.

A general comment on infectious disease is Science 283 (1999), 806-9; JAMA 281 (1999), 61-6. North American military personnel who refuse anthrax vaccination are being punished, Lancet 353 (1999), 130. Antibiotic resistant bacteria are discussed in PNAS 96 (1999), 800-1; NatMed 5 (1999), 358-9; NS (13 Feb. 1999), 34-7; NEJM 340 (1999), 556-7. The FDA has proposed to measure antibiotics in animal feed, BMJ 318 (1999), 829.

Tough debates in the UK BSE inquiry are leading to a delay in the expected report to late 1999 or further, BMJ 318 (1999), 558. Deaths from nvCJD are rising, with 9 in the last quarter of 1998 in the UK, BMJ 318 (1999), 829; Lancet 353 (1999), 939, 979. There is evidence of transmissible spongiform encephalopathy (TSE) in sheep and goats in Italy, Lancet 353 (1999), 560-1. In the UK it is also suspected that the sheep TSE could be BSE that transfered, Nature 398 (1999), 648. In Australia people having 3 medical operations are twice as likely to have CJD than those with no operations, Lancet 353 (1999), 693-7; BMJ 318 (1999), 625. Sterilizing instruments at high temperatures may increase the risk of spreading, NS (13 Feb. 1999), 18. The question of TSEs in blood is discussed in the USA in JAMA 281 (1999), 1157-8; Nature 397 (1999), 376; but Canada has lifted a ban on donors with CJD, Lancet 353 (1999), 132. There are fears that Swiss cattle could have more BSE than thought, NS (6 March 1999), 16. Primates are easily infected with TSEs, Nature 398 (1999), 449; and there have been reported cases in French zoos, Int. Herald Tribune (31 March 1999), 4. A more sensitive test has been developed, Science 283 (1999), 469-70; GEN 19 (15 April 1999), 9, 30. Ethically we can ask do we want to know if we are incubating CJD? NS (23 Jan. 1999), 3, 5.

There is currently no evidence of vaccination leading to diabetes but further studies may be useful, BMJ 318 (1999), 1159-60. Discussion of the future of international vaccination efforts with the closure of the Children's Vaccine Initiative are in NatMed 5 (1999), 469-70; NEJM 340 (1999), 1373; Science 284 (1999), 587; also JAMA 281 (1999), 1366-7, 1482-3. A report on efforts to eradicate the last pools of wild polio in Cambodia and Vietnam are reported in JAMA 281 (1999), 1690-1. There are now efforts to block a gene DNA adenine methylase that is required for disease progression in a number of diseases as a vaccine target, Science 284 (1999), 883. The WHO is targeting malaria (again), Nature 399 (1999), 99. An editorial looking at when we can cure the common cold is JAMA 281 (1999), 1844-5. A study of BCG vaccines by whole genome DNA microarray is Science 284 (1999), 1520-3. To cure disease by vaccine will be best if it is needle free, JAMA 281 (1999), 1879-81.