CDC HIV/STD/TB Prevention News Update

TB Drug Resistance Stands at 11 Percent of Cases

"TB Drug Resistance Stands at 11 Percent of Cases" Washington Post (www.washingtonpost.com) (03/24/00) P. A14; Brown, David
A new report from the World Health Organization (WHO) and other agencies shows that about 11 percent of tuberculosis (TB) cases worldwide show some resistance to standard treatment drugs. The report--a survey of 58 nations and regions--found that Russia, the Baltic countries, and China are especially hit hard with drug resistance, likely because many cases are not treated completely. Countries like Denmark, Germany, and New Zealand are also seeing increasing resistance, as immigrants arrive with the drug-resistant strains. Confirming what many experts already believed, the report concluded that directly observed therapy, in which TB patients take their medications in the presence of healthcare workers, is the best means of prevention against drug resistance. The survey is being released today, "World TB Day," as government ministers of 20 nations with high TB prevalence meet with the WHO and the World Bank in Amsterdam. The report also found that 40 percent of new TB cases in Estonia are resistant to at least one drug, with 14 percent showing multidrug resistance. Multidrug resistance appeared more often in foreign-born patients in countries such as Finland, Canada, Iran, England, and the United States.

Clinton Joins India's Battle Against Disease

Reuters (03/24/00); Holland, Steve
President Clinton helped administer on Friday the oral polio vaccine to a baby in India, noting the country's success in fighting the disease as he called for more work against AIDS, malaria, and tuberculosis (TB). Mass immunization campaigns have helped to reduce the incidence of polio in India, even though it was home to about 70 percent of the world's cases last year. Clinton said it is now time for India to fight AIDS, malaria, and TB, through research, vaccines, and increased prevention efforts. The president also announced that the United States will give $4 million more for HIV prevention and care in India, which has the highest number of people with AIDS worldwide.

Gateses Give $133 Million for Medical Advances

"Gateses Give $133 Million for Medical Advances" Seattle Post-Intelligencer Online (www.seattlep-i.com) (03/24/00)
The Bill & Melinda Gates Foundation has donated $133 million to improve access for women and children in the developing world to medical advances. The gift includes $25 million to the Global Alliance for TB Drug Development, a new group that aims to find more treatments for tuberculosis. Also, there will be $50 million for Save the Children and $15 million for the Infectious Disease Research Institute, which will use the funds to help develop a leishmaniasis vaccine. The remaining funds will go to the Medicines for Malaria Venture ($25 million) and the Albert B. Sabin Vaccine Institute ($18 million), which is working to create a vaccine against hookworm.

World TB Day: Let's Stamp Out the Lung Disease

Reuters Health Information Services (03/23/00); Bussey, Eliza
The American Lung Association plans to ask Congress for $430 million in aid to eradicate tuberculosis (TB) around the world, with $330 million going toward domestic efforts and $100 million for international TB work. At a recent press conference, the American Lung Association and the Medical Society of the District of Columbia unveiled a new effort to combat TB in the nation's capital, which has one of the highest rates in America. The city's TB rate is two to three times the national rate, even though D.C.'s rate declined 36 percent last year. Dr. Michael Richardson, chair of the TB task force at the Medical Society of D.C., noted that most TB patients in Washington, D.C., are African American, male, and unemployed.

United Nations: Fighting AIDS

New York Times (www.nytimes.com) (03/24/00) P. A10; Neilan, Terence
The United Nations Foundation will donate $6 million to help battle AIDS in southern Africa. The foundation was created by a fund formed by Ted Turner.

Pierce County Criticized for AIDS Records

"Pierce County Criticized for AIDS Records" Seattle Post-Intelligencer Online (www.seattlep-i.com) (03/23/00); Hopkins, Jack
The Washington State Department of Health has been asked by the Governor's Advisory Council on HIV/AIDS to declare the Tacoma-Pierce County Health Department non-compliant with state rules if it does not give HIV and AIDS patients a way to prevent their names from being kept on file. The county health department keeps the names indefinitely, in spite of a state mandate that they be removed within 90 days. "The fact that the Tacoma-Pierce County Health Department still retains names obtained through HIV surveillance in its case management files without clear patient consent is, we believe, a clear violation of the spirit of state board of health rules," the advisory council wrote in a letter sent to state Department of Health Secretary Mary Selecky. A review by Washington's Department of Health task force recommended changes for the local agency, including a revision of the case management forms. Currently, the forms do not have an option for rejecting the health department's role in patients' HIV care. AIDS activists fear the list of names may discourage some people for being tested for HIV.

Immune Response Shares Soar 43 Percent as Thai Doctors Back AIDS Drug

"Immune Response Shares Soar 43 Percent as Thai Doctors Back AIDS Drug" Wall Street Journal (www.wsj.com) (03/24/00) P. B6; Rundle, Rhonda L.
Immune Response Corp. saw it shares rise 43 percent on Thursday following a report that Thai researchers will recommend approval of Remune, the company's HIV drug. The announcement about Thailand comes after positive study results presented last month in Geneva. According to analysts, Remune could be useful in Thailand and other countries where combination AIDS therapies that are standard in the United States are too expensive. Whereas the drug cocktails require up to 20 pills a day taken at various times, Remune is injected every three months. First Security Van Kasper analyst Alan Auerbach notes that the drug approval system in Thailand is "very informal" and the drug should soon reach consumers; however, he adds that Remune is "too weak" to be used by itself in the United States, where a variety of proven therapies are already on the market. Remune is now being tested for use in conjunction with Agouron Pharmaceuticals' antiviral drug, Viracept.

Rise in Gonorrhea Cases Among Young English Men

Reuters (03/24/00)
Cases of gonorrhea increased 52 percent among young English men between 1998 and 1999, according to the Public Health Laboratory Service in Britain. Provisional data from around the country also indicate that gonorrhea cases among women in the same group, between 16 to 19 years of age, increased 39 percent. For all age groups, cases of gonorrhea rose 26 percent in men and 30 percent in women during the study period. The highest increases in male cases were seen in the West Midlands and southwest England, while the greatest increases for women were seen in the northern and eastern parts of the country.

HIV/AIDS in Law Enforcement: 'What-If' Scenarios

"HIV/AIDS in Law Enforcement: 'What-If' Scenarios" FBI Law Enforcement Bulletin (www.fbi.gov/library/leb/leb.htm) (02/00) Vol. 69, No. 2, P. 1; Cooley, John
The HIV epidemic has reached all facets of society, including law enforcement. While law enforcement has emphasized education, awareness, and compliance with set laws, regulations, and policies, some managers and subject-matter experts still have questions and concerns regarding fear of HIV and AIDS. Fifteen years ago, the city council in Los Angeles adopted an AIDS anti-discrimination law and subsequently established a number of workplace AIDS policies. Every city department has an AIDS coordinator who reports to the city AIDS coordinator. In the Los Angeles Police Department, the AIDS coordinator reports up-to-date information about the disease in the workplace, works with other agencies to provide medical and psychological services, and supervises all HIV- and AIDS-related department training. New issues have emerged, however, including confidentiality concerns, legal topics, and preventive measures. There are a variety of confidentiality issues, but the main ones relate to including HIV data on police reports and having officers reveal their own HIV status to fellow employees. Training, meanwhile, should review preventive measures, and managers and subject-matter experts should discuss various "what-if" scenarios to help prepare officers for real situations. Although the risk of exposure to HIV via police work is small--and following universal precautions can reduce that possibility even more--fear is still a serious issue that must be addressed. Responding quickly, directly, and consistently to officers can help alleviate their concerns, reflecting clear leadership and eliminating much of the confusion that can develop.