GLOBAL: Bush Welcomes US Move to Spend $50 Billion to Fight AIDS
Agence France Presse (04.03.08) - Friday, April 04, 2008
In a statement released Thursday, President Bush praised the House of Representatives for passing a $50 billion
reauthorization of his global AIDS program. Bush said he wanted to "thank the members of Congress who supported this legislation."
The President's Emergency Plan for AIDS Relief (PEPFAR) was first launched in 2003 with $15 billion for
treatment, care and prevention designated to 15 hard-hit countries. The new bill more than triples that amount over the next five years.
Rep. Howard L. Berman (D-Calif.), chairperson of the Foreign Affairs Committee, led an effort to win over some
lawmakers who argued the program is too expensive. He reminded them, "The 2003 legislation firmly established the United States as the leading
provider in the world of HIV/AIDS assistance for prevention, treatment and care."
"As a direct result of the extraordinarily successful law we passed five years ago, the United States has
provided life-saving drugs to nearly 1.5 million men, women and children," Berman told the House. PEPFAR has helped support the care given to
another 7 million people, including 2.7 million AIDS orphans and vulnerable children, and has "prevented an estimated 150,000 infant infections
around the world," he said.
PEPFAR has "reminded the global community that Americans are a compassionate and generous people, and so has
helped to repair our nation's badly-damaged image overseas. In many ways, [PEPFAR] has had great healing power," Berman noted.
INTERNATIONAL NEWS
GLOBAL: UN Sees Progress Inadequate on Children and AIDS
Patrick Worsnip
Reuters (04.03.08) - Friday, April 04, 2008
On Thursday, UNICEF reported there have been some improvements for children facing AIDS, but progress is still
far short of goals set for 2010. Three years ago, UNICEF established targets on reducing mother-to-child (MTC) HIV transmission, supplying
pediatric AIDS drugs, preventing HIV among adolescents, and caring for children with HIV/AIDS.
In 2006, the number of HIV-positive pregnant women in middle- to low-income countries who received treatment to
prevent MTC transmission increased to 350,000, up 60 percent from 2005. In those countries, the proportion of infected women receiving drugs to
reduce the HIV risk to their babies grew from 10 percent in 2004 to 23 percent in 2006, still much lower than UNICEF's 80 percent target for
coverage by 2010. In 2006, there were 1.5 million births to HIV-positive women in low- and middle-income countries. UNICEF noted "steady
progress" in eastern and southern Africa, home to the majority of newly infected children.
More than 125,000 children with HIV were receiving treatment in 2006, UNICEF said, a 70 percent increase from
2005. "Yet, with millions of children and women not being reached, these results are in no way satisfactory," the report said. Government-
provided services are still reaching only a low percentage of those in need, it added.
"Poor geographical service reach, aggravated by weak health systems, and the fear, stigma, and denial that
discourage many women from being tested for HIV are significant barriers to wider coverage," the report said. "Community mobilization and
family support, especially from men, for women who are HIV-positive remain urgent priorities."
CANADA: Latest Figures Show Manitoba's Rate of Chlamydia Infections Is Climbing
Jen Skerritt
Canadian Press (03.31.08) - Friday, April 04, 2008
Manitoba logged 3,815 cases of chlamydia from January to September 2007, the Public Health Agency of Canada
reports. The resulting prevalence of the STD in the province is more than 400 cases per 100,000 people.
It is too early to tell whether the increase indicates that more infections are occurring or that more people are
presenting for testing, said Dr. Joel Kettner, chief medical officer of health for the province. "The short answer is I don't know," he said.
"This isn't easy work, and I'm not going to pretend it's always successful."
Of the new chlamydia cases, most are concentrated in the Burntwood and Winnipeg health regions, and those ages 15
to 49 are most likely to be infected.
Even so, Manitoba had made progress against two other STDs: The numbers of gonorrhea and syphilis cases were
down. From January to November last year, the province saw about 200 fewer gonorrhea infections, and just two people tested positive for
syphilis.
Kettner noted that last year the province switched from a urethral swab for chlamydia to a urine test, and this
may have encouraged more people to consent to testing.
MEDICAL NEWS
UNITED STATES: TB Spread from Donor to Recipient Needs Fast Action
Reuters (04.03.08) - Friday, April 04, 2008
The spread of TB from an infected organ donor to transplant patients may go undiagnosed while causing unusual
symptoms and widespread infection in the recipients, a new report suggests.
In June 2007, a 46-year-old organ donor with a history of alcoholism, incarceration, and homelessness died of
presumed aspiration pneumonia. The donor had been hospitalized three times in the preceding six months, but TB skin tests were negative. Three
weeks after his death, a spinal fluid culture grew TB.
Three organ recipients who received the donor's liver and kidneys were notified of the infection in late July,
when they began TB therapy.
A 50-year-old woman who received a kidney from the donor developed pancytopenia, a depletion of red and white
blood cells as well as platelets. Her symptoms included fever, and six weeks after the transplant she developed a sepsis-like syndrome, which
lead to her death three weeks later.
Another kidney recipient, aged 23, developed fever, severe headache, and pancytopenia seven weeks later. However,
she fully recovered after beginning TB treatment.
A 59-year-old man who received the liver never developed TB.
A genetic analysis of the organ donor's TB and the transplant patients' TB showed they were identical, reported
Dr. V. Kohli of Integris Baptist Medical Center in Oklahoma City and colleagues. "Investigations of potential donor-transmitted TB require
rapid communication among physicians, transplant centers, and public health authorities," they wrote.
The authors recommended the collection from prospective donors of detailed information relating TB risk factors;
mycobacterial testing and X-ray assessment when risk factors are identified; obtaining a specimen for routine bacterial testing; and preserving
donor blood and tissue samples suitable for lab evaluation.
TB should be considered when, within the first few weeks after organ transplantation, "the patient has persistent
fever, pneumonia, meningitis, septic arthritis, kidney complications, septicemia, graft rejection, or bone marrow suppression," notes an
editorial accompanying the report.
The full article, "Transplantation-Transmitted Tuberculosis - Oklahoma and Texas, 2007," was published in CDC's
Morbidity and Mortality Weekly Report (2008;57(13):333-336).
RUSSIA: Rapid HIV Testing and Prevention of Perinatal HIV Transmission in High-Risk Maternity Hospitals in St.
Petersburg, Russia
Dmitry M. Kissin, MD, MPH; Natalia Akatova, MD; Aza G. Rakhmanova, MD, MPH; Elena N. Vinogradova, MD, PhD; Evgeny E. Voronin, MD, PhD;
Denise J. Jamieson, MD, MPH; M. Kathleen Glynn, DVM, MPVM; Alexey Yakovlev, MD, PhD; Joanna Robinson, MSc; William C. Miller, MD, PhD, MPH;
Susan Hills, MS, PhD
Am J Obstetrics & Gynecology Vol. 198; No. 2: P. 183.e1-183.e7 (02..08) - Friday, April 04, 2008
To evaluate the effectiveness of an HIV rapid testing (RT) program, the researchers offered point-of-care RT -
including antiretroviral prophylaxis for positive women and their infants - to pregnant women with no or incomplete HIV testing results
(negative tests at <34 weeks, none thereafter) at two high-risk maternity hospitals.
From April 13, 2004, to April 13, 2005, 89.2 percent of eligible women (3,671/4,117) underwent RT, of whom 90.4
percent received results prior to delivery. Among all women who underwent RT, HIV prevalence was 2.7 percent (100/3,671); among previously
untested women, prevalence was 6.5 percent (90/1,375). The incidence of HIV seroconversion among women with previous negative tests during
pregnancy was 0.4 percent (10/2,296). Adjustment found the main predictor of receiving RT results post delivery was late admission. Among HIV-
exposed infants, 97.9 percent (92/94) received prophylaxis; 61.7 percent (58/94) had available follow-up data, and 8.6 percent (5/58) met
criteria for definitive or presumptive HIV infection.
"The RT program achieved timely detection of HIV-infected women in labor with unknown HIV status and effectively
prevented perinatal HIV transmission," the authors concluded.
LOCAL AND COMMUNITY NEWS
CALIFORNIA: San Joaquin Focusing Its HIV Prevention Efforts Toward County's Migrant Workers
Jennifer Torres
Stockton Record (03.29.08) - Friday, April 04, 2008
San Joaquin County public health experts are reaching out to the migrant laborers who have returned this season
to area farms, offering HIV education and testing.
As they move across state and national borders, migrant workers are at high risk of HIV/AIDS. A 2007 report from
the Office of the Mexican Secretary of Health notes that many migrants are impoverished and poorly educated. Once in the United States, they
encounter relaxed social norms. Many are away from their families for extended periods and engage in risky sexual behavior. A 2004 study
published in the Journal of Acquired Immune Deficiency Syndromes found immigrants from Puebla and Morelos, two states with high migration
numbers, had more sexual partners than those who did not leave Mexico, and they were more likely to have had sex with prostitutes.
At the same time, migrants are unlikely to seek out or have access to medical attention, and the subject of STDs
remains taboo. Richard Gonzales, a community health outreach worker for the county, said it is often difficult to persuade migrant workers to
get tested for HIV.
At a recent visit to farm barracks, Gonzales offered burritos and $5 gift certificates to Rancho San Miguel
Market to men who agreed to get tested and pick up their results at an April health fair. County public health personnel have made at least
three visits this year to administer HIV tests to migrant laborers, he said.
Celso Martinez of Oaxaca, who first came to work in California 14 years ago, agreed to get tested in the Public
Health Services van. "Part of you doesn't want to know," said the 31-year-old. "But I know that it's important to know."
GEORGIA: Gay Church Hosts Free Clinic
Matt Schafer
Southern Voice (Atlanta) (04.04.08) - Friday, April 04, 2008
Rapid-result HIV tests, STD screening, blood pressure monitoring and eye exams are among health services to be
offered at a free health clinic on April 12 at First Metropolitan Community Church of Atlanta.
Although several hundred people are expected to take part, the seven-hour event will be structured to provide
time for individual consultations, said Dale Maddox, a registered nurse who works at Northside Hospital's oncology ward. "People will have one-
on-one times with nurses and health professionals they normally wouldn't have, and it's free," she said.
The health fair's STD screening comes at an opportune time, given the recent CDC data showing a rise in syphilis
cases, especially among men who have sex with men (MSM).
"Syphilis, like other STDs, can increase the likelihood of HIV transmission two- to five-fold," Dr. Hillard
Weinstock, chief of surveillance in CDC's epidemiology and surveillance branch in the division of STD prevention, said during a recent media
briefing. "For individuals already infected with HIV, syphilis may increase viral load, which can accelerate HIV disease progression and
potential for HIV transmission. The CDC recommends that sexually active [MSM] get tested for syphilis, HIV, and other STDs at least annually."
The Feminist Women's Health Center will offer counseling to lesbians considering becoming pregnant. "We are one
of the few providers in the South to offer this opportunity to women regardless of partner status or orientation," said Whitney Watts, the
center's legislative organizing coordinator. In addition, "We will be there with our lesbian-friendly guide to STDs and our normal activism
information, of course. We still hear from our lesbian clients that they are not susceptible to developing STDs - and diseases, we know, do not
discriminate."
The church is located at 1379 Tullie Rd., near the intersection of I-85 and North Druid Hills Road; telephone
404-325-4143.
NEWS BRIEFS
NEVADA: Guinan Named Acting Nevada State Health Officer
Associated Press (04.03.08) - Friday, April 04, 2008
Dr. Mary Guinan has been named acting state health officer of Nevada. "As governor, I have asked Dr. Guinan to
lead a team of medical and scientific experts to examine circumstances surrounding the cluster of acute hepatitis C cases linked to an
ambulatory care facility in Las Vegas and make recommendations on the changes needed to prevent future occurrences," said Gov. Jim Gibbons in a
statement issued jointly with Health and Human Services Director Mike Willden. Officials have traced at least six hepatitis C infections to the
Endoscopy Center of Southern Nevada, where staff members regularly reused syringes and medication vials. Guinan held the state health officer
post from 1998 to 2002 and is currently dean of the School of Public Health at the University of Nevada-Las Vegas. As a doctor and researcher,
she also worked at CDC in various capacities for over 20 years.
OHIO: Hundreds Get Hepatitis Vaccination After Restaurant Warning
Associated Press (04.03.08) - Friday, April 04, 2008
Butler County Health Department officials, who are responding to a hepatitis A diagnosis in a food worker at P.F.
Chang's China Bistro in West Chester, went through 800 vaccination doses and had to turn people away from a clinic on Wednesday. The state
Department of Health has advised people who ate at the popular eatery March 14-25 to contact their doctor or local health department. County
health officials said they will schedule another clinic as soon as they can obtain more vaccine. Though no new cases have been reported
locally, health departments nationwide were notified due to the large number of visitors to this southwest Ohio community, where the state's
first Ikea store opened last month. For more information, telephone the Butler County Health Department at 513-863-1770 or visit
http://www.butlercountyohio.org/Health.
MINNESOTA: Health Officials Suspect TB Case at Burnsville High School, Again
Emily Johns
Star Tribune (03.29.08) - Friday, April 04, 2008
The Burnsville-Eatan-Savage School District is sending letters to staff and parents of students at Burnsville
High School notifying them that a person at the school is suspected of having tuberculosis. A separate letter recommends TB testing for any
person who came in close contact with the infected individual. The district was informed of the TB infection by Dakota County health officials.
A similar incident occurred at the school last year; no one was found to be infected. Questions concerning the case can be directed to a public
health nurse at the county Public Health Department; telephone 952-891-7500.
GEORGIA: Emory Hosts Symposium on HIV
Matt Schafer
Southern Voice (Atlanta) (04.04.08) - Friday, April 04, 2008
On April 8, the Emory Center for AIDS Research will host the expert symposium "Antiretroviral Therapy: Prolonging
Survival, Decreasing Transmission, Aiming for Virus Eradication." While the conference is primarily geared toward researchers, it is also open
to the public. Reservations are required; e-mail cfar@emory.edu.
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