From: Billi Goldberg <bigoldberg@igc.apc.org>
Subject: CDC Summary 10/2/92
Note: Copyright 1992, Dan R. Greening. Non-commercial reproduction allowed.
Archive-Number: 6268
Organization: unspecified
Date: Fri, 2 Oct 92 08:33:04 PDT

                          AIDS Daily Summary
                          October 2, 1992 
 The Centers for Disease Control (CDC) National AIDS Clearinghouse makes 
available the following information as a public service only.  Providing 
this information does not constitute endorsement by the CDC, the CDC 
Clearinghouse, or any other organization.  Reproduction  of this text is 
encouraged; however, copies may not be sold.  Copyright 1992, 
Information, Inc., Bethesda, MD 
************************************************************************
 "Migrants Said to be Susceptible to AIDS, TB" Washington Post 
(10/02/92), P. A3
     Migrant workers may be 10 times more likely to contract HIV as  the 
typical American, and about half are infected with  tuberculosis, 
reported the Centers for Disease Control yesterday. The CDC said in its 
"Morbidity and Mortality Weekly Report" that  5 percent of all adults 
tested at migrant farm worker camps in  the rural southwest Florida town 
of Immokalee were HIV-positive.  The majority were unaware of their 
infection, said the CDC, and  several did not know how HIV is 
transmitted or how it could be  prevented.  Joann Schulte, a CDC 
preventive medicine specialist,  said the rate of HIV infection among 
migrant farm workers was 10  times the predicted 0.5 percent infection 
rate for the entire  United States.  She added that the infection rate 
for the test  group was only slightly higher than the rate found in 
other  migrant farm worker camps in Florida.  In addition, the CDC  
discovered that 44 percent of the migrant workers were infected  with 
TB, even though only one person was found to have an active  infection.  
Schulte said the TB rate "is consistent with what has been found in 
other studies of migrant farm workers and it's  about the same as the 
level of TB in some inner-city areas." 

"Doctors Testing AIDS Vaccine on Area Patients" Richmond Times-Dispatch 
(10/02/92), P. B1  (Orndorff, Beverly)
     Researchers in the greater Richmond, Va., area are currently  
testing an AIDS vaccine on HIV-positive volunteers.  The vaccine  being 
used in the tests is the gp160 vaccine.  The purpose of the tests is to 
determine whether a series of injections of gp160  will postpone or stop 
the progression of HIV infection to  full-blown AIDS.  The Richmond site 
is one of four locations in  the country chosen to test the vaccines by 
the National  Institutes of Health.  The studies are being conducted by 
the  Richmond AIDS Consortium, a group of 18 physicians at MCV  
Hospitals, the McGuire Veterans Affairs Medical Center, the  Cross-Over 
Health Services clinic and in private practice.  The  group provides 
research therapies for many local HIV-positive  patients with a grant 
from the National Institutes of Health.   The gp160 designation for the 
experimental vaccine alludes to one of the many proteins that exist on 
the AIDS virus' outer  envelope.  HIV contains an inner core of 
infecting material--DNA  or RNA--and an outer protein envelope.  The 
protein envelope does not infect individuals, and vaccines based on 
components of it  carry no risk of passing along the disease, indicated 
Dr. Thomas  Kerkering, who is leading the study.  The researchers hope 
that  gp160 will inhibit the virus in the patients bodies, making it  
unable to infect other cells.  A total of 35 volunteers have  enrolled 
in the study since it began in July, but Dr. Kerkering  said that its 
possible the tests will be expanded. 

"Council Override of Condom Veto Fails" Boston Globe (10/01/92), P. 28  
(Rezendes, Michael)
     The controversial condom vending machine law in Boston that was  
vetoed by Mayor Raymond Flynn and was expected to be overridden  on 
Wednesday did not have the nine votes needed to reverse the  veto.  The 
law would have required most bars and restaurants to  install condom 
vending machines as a means to help prevent the  spread of HIV in the 
city.  The city council also refused to  adopt a compromise voluntary 
proposal after it failed to override the veto.  Following one of the 
most bitter debates, Councilor  David Schondras (Fenway) lost his motion 
to override the mayor's  veto on a 7-5 vote, and attributed the defeat 
to interference by  Flynn.  He said, speaking as if the mayor were 
there, "Mr. Mayor, would you please get your personal beliefs out of the 
way of  public health policy?"  He added, "If you're uncomfortable  
dealing with sexual issues--seek therapy!  Most of us are not  that 
uptight."  But City Councilor James Kelly (South Boston), an adversary 
of the condom machine law, promptly defended the mayor  and accused 
Scondras of assailing Flynn's morals.  The dispute  over the override 
heated when Councilor Thomas Menino (Hyde  Park), who had previously 
voted in favor of the condom law,  introduced a substitute ordinance 
that would permit private  businesses seeking exemptions to the condom 
machine law to obtain them.  Menino denied the accusation that he 
proposed the  compromise in accordance with the mayor and said he 
introduced it because he had come to believe Flynn's assertion that the 
law as  originally passed violates state law and could not withstand a  
legal challenge. 

"Wilson Vetoes Needle Exchange Program" United Press International 
(10/01/92)  (Appel, Ted)
     Sacramento--Gov. Pete Wilson has vetoed a bill that would have  
legalized a clean needle exchange program in San Francisco and  enabled 
other cities to implement similar programs to fight AIDS. The needle 
exchange bill, introduced by Assembly Speaker Willie  Brown (D-San 
Francisco), was intended to curb the spread of HIV  by allowing addicts 
to exchange dirty needles for clean ones.   But Wilson cited a study 
that showed the distribution of clean  needles facilitates drug use and 
weakens the credibility of  anti-drug messages.  He said the program 
could serve as an  attraction for drug users from other cities and lure 
them to San  Francisco, possibly increasing the spread of HIV in the 
city.  In the state of California, it is currently a misdemeanor to  
distribute hypodermic needles without a prescription.  AIDS  activists 
in San Francisco have run a needle exchange program for several years 
and want to legalize the practice.  Despite  Wilson's veto, a Yale 
University study reported a 32 percent  decline in HIV infections after 
a needle exchange program in New  Haven, Conn., was implemented.  The 
study discovered that used  needles stayed on the streets only six days, 
down from an average of 2.5 weeks, and more addicts sought drug 
counseling as a result of the program.  Brown spokesman Jim Lewis said 
that about  one-third of the 200,000 reported AIDS cases in the U.S. are  
linked with IV-drug use.  Among the 11,000 people who contracted  HIV 
through heterosexual sex, 53 percent were partners of IV-drug users, 
said Lewis.

"Focus on AIDS Puts Other Sex Diseases on Back Burner, Expert Says" 
United Press International (10/01/92)
     Bloomington, Ind.--Because there is such a strong emphasis on  AIDS 
prevention, other sexually transmitted diseases have been  all but 
ignored.  Every year in the United States, about 2.5  million teenagers-
-one in every six--contracts an STD.  Sexuality educator William Yarber, 
professor of applied health science at  Indiana University, said 
regarding the importance of AIDS over  STDs, "Certainly we can 
understand that, given the seriousness of the AIDS/HIV problem.  But as 
a result, other sexually  transmitted diseases have not been discussed 
in health education  and sexuality education programs."  He added, 
"That's unfortunate because a young person has a much greater chance of 
acquiring an  STD other than HIV."  According to statistics, young 
people are  much more likely to acquire chlamydia, genital herpes, 
genital  warts, gonorrhea, or syphilis.  Young women can experience  
catastrophic effects from lower genital tract infections that do  not 
occur until later in life.  If they are left untreated,  cervical 
gonorrhea and chlamydia lead to pelvic inflammatory  disease that can 
yield chronic pelvic pain, infertility and  ectopic pregnancy. 

"Officials Mull Using Plastic Penises in AIDS Course" United Press 
International (10/01/92)  (Lyle, Morgan)
     Albany, N.Y.--Officials at the New York State Division for Youth  
are contemplating whether to use 158 artificial penises the  agency 
purchased for AIDS education at state youth facilities, a  spokesman 
announced Thursday.  A division employee bought the  items for $1,500 in 
March at the urging of a consultant training  employees in AIDS 
prevention education, but without official  authorization, said 
spokesman James Atkins.  The life-like models would replace bananas used 
to show condom use at centers for  troubled youths.  He said, "On the 
surface it may seem humorous,  but at the bottom this is a deadly 
serious matter.  These kids  are the most high risk kids in the state."  
Atkins did not  disclose the name of the employee who purchased the 
devices, but  said he no longer works for the division.  The employee 
was not  fired or disciplined over the matter.  Atkins said, "The  
consulting firm uses them in their own programs.  There are  different 
schools of thought.  One is that you should use  something that is as 
anatomically correct as possible, because  you don't want any ambiguity 
or uncertainty or doubt" about how  condoms are used.  He added, "The 
other side of the coin is that  some people are uncomfortable with that 
kind of situation."  A  decision on whether to use the models will be 
made soon,  according to Atkins.  The purchase of the items and the 
services  of the consulting firm were paid for out of a $150,000 grant 
from the state AIDS Institute, said Atkins.

"U.S. Refuses to Yield Royalties on AIDS Test" Chemical and Engineering 
News (09/21/92) Vol. 70, No. 38, P. 5   (Zurer, Pamela)
     A proposal by French researchers that would give the Pasteur  
Institute the majority of about $8 million per year in royalties  from 
the controversial blood test for HIV has been rejected by  the Bush 
administration.  According to the Pasteur Institute, its researchers--
not National Institutes of Health AIDS Researcher  Robert C. Gallo--were 
the first to discover HIV and to develop a  test to find it in blood.  
Nonetheless, Gallo was granted a  patent on the test in 1985, while 
Pasteur filed its application  first.  Subsequently, the French sued to 
overturn the patent,  though before the suit reached the court, the U.S. 
and French  governments agreed in 1987 to a settlement in which the U.S. 
and  Pasteur share the test royalties.  Pasteur Institute director  
Maxime Schwartz said that the settlement should be changed  because 
Gallo admitted last year that his lab was using the  French virus when 
it developed its test.  However, Gallo said he  was still the first to 
invent the blood test, no matter whose  virus was used.  The Pasteur 
Institute proposed royalty  reallocation at the mid-September annual 
meeting of the trustees  of the French + American AIDS Foundation.  
Nevertheless, their  proposal was denied by the U.S. trustees, who 
include Gallo and  three other federal officials.  Robert C. Odle Jr., 
one of  Pasteur's attorneys, said that the institute may take the matter  
to court, or urge Congress to name a special prosecutor to  investigate.

"African AIDS Toll" Science (09/18/92) Vol. 257, No. 5077, P. 1627
     AIDS is likely to decrease the projected population in the  African 
countries it affects the most by 20 million during the  next 25 years, 
according to the most recent United Nations world  population 
estimations.  A total of 15 countries in Africa have  the highest rates 
of HIV in the world.  The UN predicts that by  2015, AIDS will be 
directly responsible for 13 million additional deaths in these 
countries.  Although over 13 million will die of  AIDS, many of them 
would have died prematurely from other causes. Also, because AIDS will 
affect women in their reproductive years, about 7 million fewer children 
will be born.  While the toll is  alarming, the UN says Africa's 
population is still expected to  double by 2015. 

"BCG Vaccination in Children Born to HIV-Positive Mothers" Lancet 
(09/26/92) Vol. 340,. No. 8822, P. 799  (Green, S. D. R.)
     Administering BCG (bacillus Calmette-Guerin) vaccine near birth  
should not be discontinued now in Africa, though it is not  necessary 
when a child is that young, write S.D.R. Green et al.  of the University 
of Edinburgh in Kimpese, Zaire.  The  researchers reported only one case 
of probable disseminated BCG  infection in a child of five months who 
was vaccinated a three  months and developed suppurating axillary BCG 
adentitis.  Many  cases of TB in children infected with HIV simulate the 
adult form with cavitation and extensive pneumonias but only in children  
over two years old.  This is probably a result in progression of  the 
primary focus rather than reactivation or progression of BCG  
vaccination.  These children respond well to short-course therapy but 
tend to relapse and have chronic problems because of lung  damage.  HIV 
infection in infants has a bimodal presentation,  with the early 
presenters having symptoms by twelve months, while only a few late 
presenters will have them.  While there is some  evidence that BCG at 
three months produces a larger induration,  more frequent scar 
formation, and less lymphadenopathy than if it is given at birth, in 
African countries this is not the time to  change the policy of giving 
BCG near birth.  Attendance at  vaccination clinics stops quickly after 
the measles vaccine at  nine months so many healthy children would not 
receive BCG.  But  a good case could be made for chemoprophylaxis for 
children of  HIV-positive mothers who have had TB in the previous two 
years. 

"Tuberculosis and HIV Infection in Sub-Saharan Africa" Journal of the 
American Medical Association (09/30/92) Vol. 268,  No. 12, P. 1581  (De 
Cock, Kevin M. et al.)
     Just as prior to the AIDS epidemic Africa suffered  
disproportionately from tuberculosis, now the continent is  
disproportionately affected by AIDS, and is increasingly  overwhelmed by 
the epidemic of HIV-associated tuberculosis, write Kevin De Cock et al. 
of the Centers for Disease Control in  Atlanta, Ga.  Researchers 
reviewed the epidemiologic, clinical,  and pathological characteristics 
and the public health  implications of HIV-associated TB in sub-Saharan 
Africa and found high prevalences of HIV infection in patients with TB 
in East,  West, Central, and Southern Africa.  A rise in TB cases has 
been  reported at the same time as the emergence of AIDS in several  
countries.  Autopsies in Abidjan, Ivory coast (Cote d'Ivoire),  have 
demonstrated that TB is the most common opportunistic  infection in 
patients dying of AIDS.  Of the clinical differences reviewed in 
patients with TB who were HIV-positive and  HIV-negative, the most 
important was a greatly increased  mortality rate in HIV-related 
disease.  Due to the fact that TB  is ubiquitous, contagious, 
preventable, and curable, its control  in developing countries must be 
an international public health  priority.  Access to HIV testing is 
essential for complete  diagnosis, for clinical care and counseling, and 
for public  health surveillance.  The researchers conclude that the  
epidemiology of tuberculosis has been greatly affected by the  AIDS 
epidemic in sub-Saharan Africa. 
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