News Trends Analysis

Dec. 1, 2003
THE OBSERVATORYDecember 2003News
Bone disease linked to SARS cocktail.In Hong Kong, the focus is on the controversial cocktail drugs antiviral ribavirin and steroids used in recent months to treat SARS patients. Some of those patients are now suffering from avascular necrosis. Loss of blood supply to the bone can cause the problem, through an injury or by certain risk factors such as some medications like steroids, blood-coagulation disorders or excessive alcohol use. Also, increased pressure within the bone can cause the blood vessels to narrow, making difficult the delivery of adequate blood via the vessels to the bone cells. The disease can be disabling, with victims often needing joint replacements. The link between avascular necrosis and heavy use of steroids is well documented. A hospital chief from Singapores SARS-designated hospital announced that in the future, SARS patients would be treated with the HIV drug, Kaletra, and ribavirin, since this combination has a lower dosage of steroids.SARS preparedness is key.The World Health Organization (WHO), along with an independent scientific advisory panel, recommended tightening diagnostic testing procedures for the SARS virus unless a cluster of cases develops and other infectious agents have been ruled out. SARS testing is still in the development stages. The recommendation of limiting SARS testing is based on the fact that there is not enough serum containing antibodies needed for diagnostic testing. Dr. John MacKenzie, an Australian microbiologist from WHO and the panels leader, states, The last thing we want is a number of false positives, so not everyone should be tested. in places hard hit last winter, any person with atypical pneumonia should be immediately tested for SARS. If a laboratory does come up with a positive SARS test result, it must send the specimen to a second laboratory that belongs to the WHO network for independent validation.The Centers for Disease Control and Prevention (CDC) posted the working draft version of its Public Health Guidance for Community-Level Preparedness and Response to Severe Acute Respiratory Syndrome. For more information about the SARS Plan, visit CDCs website at:
or contact the Office of Communication at (404) 639-3286.
Flu detection chip underway.An electronic chip being developed will rapidly pinpoint whether a patient has flu, dengue fever, SARS or other respiratory illnesses. The government-run Genome Institute of Singapore says it hopes to launch the respiratory pathogens detection chip as early as next month. Sputum or nasal fluid is dropped onto the chip, and detection probes diagnose the pathogen. Patients who have flu, dengue fever or SARS all exhibit similar symptoms in the early stages. The chip will identify the virus from the start, says the Institutes deputy director.Smallpox prime bioterror weapon.Officially, smallpox only exists in a CDC freezer in Atlanta and at a virology institute in Novosibirsk, Russia. Disease experts attending Octobers WHO conference in Geneva say they believe stocks may be hidden in other countries. According to the U.S. government, Iran, Libya and North Korea are potential sources of biological agents, especially smallpox. The WHO says that 90% of the worlds population is susceptible to the virus. Peter Jahrling, an adviser to the U.S. Army Medical Research Institute, says, We have no doubt that we will see new attempts to use biological agents for attacks. How soon and what agent we dont know. The smallpox virus spreads fast and is difficult to diagnose because it incubates around 10 days before causing fever and lesions. Jahrling adds, The United States has made rapid progress in diagnostics since the 9/11 attacks, and now has access to 300 million doses of smallpox vaccine.TestingCall for rare tests.The 10th edition of AACC Press
Directory of Rare Analyses (DORA) 2004 will contain detailed listings of uncommon tests with the address and contact person for the laboratory performing the test. If your laboratory performs unusual tests and you wish to submit them, visit DORA online at Test submissions will be accepted only online with a January 31, 2004 deadline. DORA-related questions should be directed to managing editor Joanna L. Grimes at (800) 892-1400 or e-mail
[email protected].
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