ATW1H%ASUACAD.BITNET@oac.ucla.edu (Dr David Dodell) (07/05/89)
--- begin part 2 of 2 cut here ---
Medicine 1982;61:189-97.
5. Kilbourne EM. Illness due to thermal extremes. In: Last JM, ed. Maxcy-
Rosenau--public health and preventive medicine. 12th ed. New York: Appleton-
Century-Crofts, 1986:703-14.
6. Kilbourne EM, Choi K, Jones TS, Thacker SB. Risk factors for heatstroke: a
case-control study. JAMA 1982;247:3332-6.
7. Pitts GC, Johnson RE, Consolazio FC. Work in heat as affected by intake of
water, salt and glucose. Am J Physiol 1944;142:253-9.
8. Lee DHK. Seventy-five years of searching for a heat index. Environ Res
1980;22:331-56.
9. Steadman RG. A universal scale of apparent temperature. J Climate Applied
Meteorol 1984;23:1674-87.
*Deaths attributed to excessive heat exposure are coded E900 according to the
International Classification of Diseases, Ninth Revision.
Health InfoCom Network News Page 10
Volume 2, Number 27 July 3, 1989
**Based on "State Areally Weighted Temperatures" provided by the National
Climatic Data Center, National Oceanic and Atmospheric Administration.
Health InfoCom Network News Page 11
Volume 2, Number 27 July 3, 1989
Update: Aedes albopictus Infestation -- United States, Mexico
Aedes albopictus, a mosquito of Asian origin, was discovered in Texas in
1985 (1,2). This mosquito transmits dengue virus in Asia (3,4) and under
laboratory conditions can transmit pathogenic viruses indigenous to the United
States (5).
Surveillance for Ae. albopictus in the eastern United States was initiated
in 1986; by 1988, infestations had been found in 113 counties in 17 states
(Figure 1, page 445) (6-8). In 1988, the mosquito was also found in a tire in
Matamoros, Mexico. This is the southernmost identification of Ae. albopictus
in North America; however, subsequent surveys in Matamoros have not detected
further evidence of infestation. Separate infestations of Ae. albopictus,
originating from tropical Asia, have been established in four Brazilian states
(6).
Ae. albopictus was probably introduced into the United States in used-tire
casings imported from Asia (9). On January 1, 1988, new regulations were
implemented to control the importation of used-tire casings originating in
Asian countries. These regulations require that used-tire casings be clean and
dry and be treated by one of three approved fumigation procedures. During
1988, 34 (0.5%) of 6533 casings examined in U.S. ports contained water--a 98%
reduction from levels found in earlier surveys (9). During 1988, no viruses
were isolated from 10,679 Ae. albopictus specimens from Indiana, Illinois,
Tennessee, and Louisiana.
Reported by: State and local health and vector-control agencies in
Alabama, Arkansas, Delaware, Florida, Georgia, Illinois, Indiana, Kentucky,
Louisiana, Maryland, Mississippi, Missouri, North Carolina, Ohio, Oklahoma,
South Carolina, Tennessee, Texas, and Virginia. KJ Tennessen, Tennessee Valley
Authority, Muscle Shoals, Alabama. TW Walker, Aberdeen Proving Ground,
Maryland. J Sepulveda-Amor, MD, Direccion General de Epidemiologia, J
Fernandez de Castro, MD, Direccion General de Medicina Preventiva, Secretaria
de Salubridad, Mexico City, Mexico. Div of Quarantine, Center for Prevention
Svcs; Div of Vector-Borne Viral Diseases, Center for Infectious Diseases, CDC.
Editorial Note: The public health importance of the introduction and
infestation of Ae. albopictus in the United States remains undetermined. The
potential for Ae. albopictus to transmit certain pathogenic arboviruses
indigenous to the United States has been proven in laboratory experiments (5);
however, disease transmission by this mosquito in natural settings has not
been documented. La Crosse virus, a leading cause of childhood encephalitis in
the upper and midwestern United States, is usually restricted to rural areas
by the behavior of its principal vector mosquito, although the virus could
extend to urban centers if carried by Ae. albopictus. La Crosse virus has not
been isolated from Ae. albopictus, and no case of encephalitis has been
epidemiologically attributed to this mosquito.
The potential for dengue virus transmission in the United States by Ae.
albopictus is of particular concern. The principal vector of dengue virus, Ae.
aegypti, is prevalent throughout the Southeast but cannot overwinter in
northern states. However, because Ae. albopictus can overwinter as far north
as latitude 42 N and in summer can extend even farther north, the risk for
epidemic dengue in the United States is heightened.
In suburban areas of New Orleans with abundant vegetation, Ae. albopictus
has replaced Ae. aegypti and has become the principal source of mosquito
complaints to the health department. Ae. aegypti remains dominant in urban
areas where housing density is high and vegetation is sparse.
Although Ae. albopictus now is entrenched in the United States, continued
monitoring of imported used-tire casings is needed to prevent further
Health InfoCom Network News Page 12
Volume 2, Number 27 July 3, 1989
introductions of this mosquito and to prevent the introduction of other exotic
mosquito species and Asian arboviruses (9). Spot surveys support the
effectiveness of the new regulations regarding the importation of tires from
Asia.
References
1. Sprenger D, Wuithiranyagool T. The discovery and distribution of Aedes
albopictus in Harris County, Texas. J Am Mosq Control Assoc 1986;2:217-9.
2. CDC. Aedes albopictus introduction--Texas. MMWR 1986;35:141-2.
3. Jumali, Sunarto, Gubler DJ, Nalim S, Eram S, Sulianti Saroso J. Epidemic
dengue hemor rhagic fever in rural Indonesia: III--Entomological studies. Am J
Trop Med Hyg 1979; 28:717-24.
4. Metselaar D, Grainger CR, Oei KG, et al. An outbreak of type 2 dengue fever
in the Seychelles, probably transmitted by Aedes albopictus (Skuse). Bull WHO
1980;58:937-43.
5. Shroyer DA. Aedes albopictus and arboviruses: a concise review of the
literature. J Am Mosq Control Assoc 1986;2:424-8.
6. CDC. Aedes albopictus infestation--United States, Brazil. MMWR 1986;35:493-
5.
7. CDC. Update: Aedes albopictus infestation--United States. MMWR 1986;35:649-
51.
8. CDC. Update: Aedes albopictus infestation--United States. MMWR 1987;36:769-
73.
9. Craven RB, Eliason DA, Francy DB, et al. Importation of Aedes albopictus
and other exotic mosquito species into the United States in used tires from
Asia. J Am Mosq Control Assoc 1988;4:138-42.
Health InfoCom Network News Page 13
Volume 2, Number 27 July 3, 1989
Notices to Readers
Publication of MMWR Recommendations and Reports on HIV and Hepatitis B
Virus in Health-Care and Public-Safety Workers
A new MMWR Recommendations and Reports, "Guidelines for Prevention of
Transmission of Human Immunodeficiency Virus and Hepatitis B Virus to Health-
Care and Public-Safety Workers," was published June 23, 1989 (1). This
document provides an overview of the modes of transmission of human
immunodeficiency virus and hepatitis B virus in the workplace, an assessment
of the risk for transmission under various assumptions, principles underlying
the control of risk, and specific risk-control recommendations for employers
and workers. This document also includes information on medical management of
persons who have sustained an exposure at the workplace to these viruses
(e.g., an emergency medical technician who incurs a needlestick injury while
performing professional duties). These guidelines are intended for use by a
technically informed audience. A separate model curriculum based on the
principles and practices discussed in this document is being developed for use
in training workers.
Reference
1. CDC. Guidelines for prevention of transmission of human immunodeficiency
virus and hepatitis B virus to health-care and public-safety workers. MMWR
1989;38(no. S-6).
Health InfoCom Network News Page 14
Volume 2, Number 27 July 3, 1989
===============================================================================
Food & Drug Administration News
===============================================================================
Gancilovir Approval
P89-30 Food and Drug Administration
FOR IMMEDIATE RELEASE Brad Stone -- (301) 443-3285
June 26, 1989 Home -- (703) 892-0468
The Food and Drug Administration today approved the drug ganciclovir to
treat an eye infection, cytomegalorivus retinitis, that can sometimes lead to
blindness in AIDS and other immune-suppressed patients.
FDA said that the drug, which is also known as DHPG, slows the progression
of cytomegalovirus (CMV) retinitis -- an eye condition caused by an
opportunistic infection effecting about one in every four AIDS patients, and
some other patients with reduced immune functions, such as organ transplant
recipients.
HHS Secretary Louis W. Sullivan, M.D., said, "This and other recent
developments in AIDS treatment demonstrate a commitment by HHS and its
component FDA to speed the availability of AIDS-related drugs."
The approval was based on several studies of ganciclovir's use as a short-
term therapy, but Dr. Sullivan and FDA Commissioner Frank E. Young, M.D.,
Ph.D., said that much remains to be learned about the drug's effects.
"To answer these questions," Dr. Young said, "the approval of ganciclovir
will be accompanied by extensive post-marketing studies to explore more fully
the drug's benefits and limitations, especially its role in use with AIDS
therapies such as zidovudine, or AZT."
The recommended treatment with ganciclovir consists of intravenous
infusions twice a day for two to three weeks, followed indefinitely by a
maintenance therapy of infusions once a day.
Syntex Corp. of Palo Alto, Calif., will market the drug under the trade
name Cytovene.
Ganciclovir has been available to some patients through a Treatment IND
program sponsored by the National Institute of Allergy and Infectious Diseases
and through other protocols sponsored jointly by NIAID and Syntex. The
program allows patients with serious or life-threatening conditions to get
pre-approval access to experimental drugs that have shown significant promise.
Although ganciclovir may slow the progression of CMV retinitis in immuno-
compromised patients, it is not a cure for the disease and not all patients
respond to it. About 40 percent of all AIDS CMV retinitis patients may be
unable to tolerate ganciclovir treatment because of the adverse affects it has
on the production of critical blood cells. Preliminary data also suggest that
ganciclovir may not be tolerated well in conjunction with therapies for AIDS
and other AIDS-related conditions are administered at the same time.
Ganciclovir was first synthesized in the early 1980s and developed as a
potential therapy against the herpes simplex virus. By 1983, further
laboratory studies by Syntex indicated that the drug might be effective
against other viruses, including cytomegalovirus.
####
R-Erythropoietin expanded premarket distribution
Health InfoCom Network News Page 15
Volume 2, Number 27 July 3, 1989
P89-31 Food and Drug Administration
FOR IMMEDIATE RELEASE Brad Stone -- (301) 443-3285
June 26, 1989 Home -- (703) 892-0468
HHS Secretary Louis W. Sullivan, M.D., announced today that the Food and
Drug Administration is permitting expanded premarket distribution of an
experimental protein product to treat the severe anemia that weakens nearly
half the 20,000 patients currently taking zidovudine, commonly known as AZT,
for AIDS. The drug will also be made available to the smaller number of AIDS
patients suffering from anemia related to the disease itself.
"The early release of this product," Secretary Sullivan said, "shows that
HHS and its constituent FDA mean business when we say we want to speed the
availability of AIDS-related drugs."
In the past, the severe anemia associated with AZT and AIDS has required
repeated blood transfusions. In some cases, AZT has had to be discontinued.
The protein product, r-erythropoietin, is a form of a protein formed in
the kidneys, erythropoietin, which stimulates the body's production of red
blood cells. Scientists are able to make quantities of the protein for
treatment through gene-splicing techniques.
Another erythropoietin product was approved by FDA on June 1, as a
treatment for anemia associated with chronic kidney failure. However, today's
action provides an experimental treatment regimen specifically designed to
treat this AIDS-related anemia. Physicians participating in the r-
erythropoietin protocol will receive the product at no cost.
FDA Commissioner Frank E. Young, M.D., Ph.D., said, "This new biotech
product should improve the quality of life for those whose lives depend upon
zidovudine. Its premarket release -- the fourth for AIDS-related products --
reaffirms HHS' and FDA's commitment to providing people with life-threatening
and serious diseases the earliest possible access to promising treatments."
FDA is a part of the Public Health Service within HHS.
In controlled clinical studies involving more than 100 AIDS patients who
had experienced severe anemia from zidovudine, r-erythropoietin appeared to
restimulate the production of red blood cells and reduce or eliminate the need
for transfusions.
The data from this study served as the basis for granting today's
"treatment IND" status. (IND stands for investigational new drug.) This status
allows patients suffering from serious or life-threatening conditions to get
pre-approval access to experimental drugs that have shown significant promise.
Under this treatment IND protocol, AZT patients and other AIDS patients
who have experienced severe anemia will be eligible to receive r-
erythropoietin treatment. The product will initially be in limited supply but
its availability will be expanded during the next several weeks.
Ortho Pharmaceutical Corp. of Raritan, N.J., will sponsor the treatment
IND protocol. The company has also filed a product license application for r-
erythropoietin which FDA is currently reviewing.
Physicians interested in the details of this treatment IND protocol can
contact an Ortho hotline at (800) 243-7739.
####
Approval of Aerosolized Pentamidine
P89-29 Food and Drug Administration
Health InfoCom Network News Page 16
Volume 2, Number 27 July 3, 1989
FOR IMMEDIATE RELEASE Brad Stone -- (301) 443-3285
June 15, 1989 (Home) -- (703) 892-0468
HHS Secretary Louis W. Sullivan, M.D., today announced Food and Drug
Administration approval of aerosolized pentamidine -- a drug inhaled into the
lungs to help prevent a form of pneumonia that frequently threatens the lives
of AIDS patients.
Although many patients have already been receiving aerosolized pentamidine
treatments through a special pre-approval distribution program, a large number
of these patients have not been able to get medical insurance reimbursement
for it. But today's approval, Dr. Sullivan said, will make the drug
affordable to more patients since it is likely most private insurance
providers will now pay for an approved drug.
"Today's approval will help many of those infected with the AIDS virus
avoid one of the most deadly opportunistic infections associated with AIDS,"
said Secretary Sullivan. "It may help an estimated 100,000 or more individuals
who are at risk of developing first or subsequent episodes of Pneumocystis
carinii pneumonia and will, therefore, significantly improve the quality of
their lives."
Dr. Sullivan noted that the cost of using aerosolized pentamidine to
prevent Pneumocystis carinii pneumonia would probably represent only a
fraction of the cost of treating patients who have developed this pneumonia,
"but, most important, it should improve the quality of life for those at
highest risk from this infection." The FDA, which approved the product, is a
part of the U.S. Public Health Service and Dr. Sullivan's department.
Today's action coincides with the Public Health Service's publication of
guidelines for prophylaxis against Pneumocystis carinii pneumonia in persons
infected with the AIDS virus. The guidelines, which appear in the June 16,
1989 issue of the Centers for Disease Control's Morbidity and Mortality Weekly
Report, are the recommendations from a panel composed of medical experts from
the Public Health Service and leading medical centers. The use of aerosolized
pentamidine to help prevent Pneumocystis carinii pneumonia is prominently
recommended in the guidelines.
Aerosolized pentamidine will be labeled for use in patients who have had
at least one episode of the pneumonia or who have greatly diminished immunity,
as indicated by CD4 helper lymphocyte cell counts of 200 or less. CD4 helper
cells are white blood cells that are critical components of the body's immune
system and which are destroyed by the AIDS virus. Healthy individuals
normally have CD4 helper cell counts of about 1,000 or more.
FDA Commissioner Frank E. Young, M.D., Ph.D., said his agency's approval
was based largely upon clinical data from a community-based study conducted by
the San Francisco Community Consortium. "The approval of this vital drug
heralds a new era of close cooperation among FDA, industry and those community
physicians who are on the front line of dealing with this terrible disease,"
Dr. Young said.
This is the first new drug approval emanating from a clinical trial
sponsored jointly by a community research initiative and a pharmaceutical
company. The trial, conducted by the San Francisco Community Consortium, a
group of physicians with experience treating people infected with the AIDS
virus, compared three dosages of the drug to determine which dose would be
most effective. In this study, headed by Bruce Montgomery, M.D., David W.
Feigel, M.D., M.P.H., and Gifford Leoung, M.D., individuals infected with the
AIDS virus who were at high risk of developing the pneumonia had a lower
incidence of infection when treated with this drug administered via the
Respirgard II nebulizer at a 300 milligram dose every four weeks than similar
Health InfoCom Network News Page 17
Volume 2, Number 27 July 3, 1989
patients treated with lower doses.
In November 1988, LyphoMed Inc. of Rosemont, Ill., which partially
underwrote the San Francisco Community Consortium study, filed the new drug
application that was approved today. Clinical data from this study continued
to be collected through December 1988, and its final results were submitted to
FDA in April 1989. In May 1989, FDA's Anti-Infective Drugs Advisory Committee
unanimously recommended that FDA approve the drug. The company will market
the approved drug under the trade name NebuPent.
The Respirgard II nebulizer, the filtered system specified in the drug's
approved labeling, is manufactured by the Marquest Corp. of Engelwood, Colo.
and is available through home health care retailers and hospital pharmacies.
Since February 1989, aerosolized pentamidine has been made widely
available to patients under the agency's "treatment IND" regulations -- a plan
for the use of an investigational new drug (IND) in selected patients facing
serious or life-threatening conditions. Despite this status, many eligible
patients were unable to receive reimbursement for the costs of this therapy
from private or government health insurance providers. Although some
companies have provided reimbursement, others were reluctant to pay until the
drug was fully approved.
Injectable pentamidine, as distinct from aerosolized pentamidine, was
approved in 1984 for the treatment of those already suffering from
Pneumocystis carinii pneumonia.
Aerosolized pentamidine can provoke severe wheezing and coughing at the
time of administration, as well as other adverse reactions. The long-term
risks associated with its use are unknown.
Health InfoCom Network News Page 18
Volume 2, Number 27 July 3, 1989
===============================================================================
Columns
===============================================================================
NEUROLOGICAL SURGEON GROUPS ENCOURAGE MEMBERS TO PARTICIPATE IN EDUCATIONAL
PROGRAMS TO INCREASE AWARENESS OF ORGAN DONATION
The American Association of Neurological Surgeons (AASN) and the Congress
of Neurological Surgeons (CNS) have adopted a joint resolution encouraging
neurological surgeons to participate "in educational programs for physicians
and the general public to increase the awareness of organ donation."
Passage of the resolution by the organizations in September of 1988
marked the first of several actions being taken to develop a more formal
relationship between neurosurgeons and the transplant community. The
resolution clearly states that "the support and involvement of neurosurgeon's
in the donation process could increase the number of available organs." (The
complete resolution follows.)
In addition, the AASN and CNS have begun a two-year collaborative
education effort with the Division of Organ Transplantation (DOT) and United
Network for Organ Sharing (UNOS) to reach out to neurosurgeons. As a first
step, UNOS, AASN and CNS recently conducted a mail survey of 3,600 AASN and
CNS members to assess neurosurgeons attitudes about organ donation and their
role in the process. Preliminary results indicated that a majority of the
respondents (63%) either agreed or strongly agreed "facilitating organ
donations is a neurosurgeon' responsibility." "Majorities also agreed that
organ donations is often a positive experience for families of brain dead
patients, that families of brain dead patients should be given the right to
choose organ donation, and that the role of raising the question of organ
donation to the family should be primarily assumed by the neurosurgeon," the
survey revealed.
According to the DOT, several other activities are being considered
including "formation of an Advisory Committee, development of a core
curriculum for neurosurgical residency programs, and co-sponsoring local and
national workshops. The complete text of the AASN/CNS resolution:
"With the advancements in medical technology and therapy, there has been
an increased frequency in organ transplants and correspondingly an improved
success rate. The supply of donor organs does not meet the increasing demand
for organs to extend life and restore health through transplantation.
Vascular organ donors must meet state and institutional requirements for
brain death. This necessitates a significant relationship between the
neurosurgeon and the potential donor's family. The support and involvement of
neurosurgeon's in the donation process could increase the number of available
organs.
The AANS and the CNS support and encourage the participation of
neurosurgeons in educational programs for physicians and the general public to
increase the awareness of organ donation."
Health InfoCom Network News Page 19
Volume 2, Number 27 July 3, 1989
Study Participating Request
I am urgently seeking single fathers, in any category, to participate in an
anonymous, confidential study of single fathers that is part of my ongoing
program of research. Should you know of individuals in this broad category who
would be willing to participate, or if you are yourself a single father
willing to participate, I would very much appreciate your responding to my
plea. The research project will be conducted by mail, e-mail, and telephone--
where indicated; and project findings will be shared with participants who
request them. The required commitment of time is minimal; and I believe that
participation will be helpful and informative to all concerned. At this point
I am seeking potential participants, after which I will be communicating with
each at a more personal level: again by mail, e-mail, or telephone. I am a
certified clinical social worker, a licensed psychologist, and a social work
faculty member at the University of Vermont, Burlington. Please direct
responses (and I'd really be excited to see lots of them) to me at the
following address(es) or telephone numbers. Be assured that your help is very
much appreciated. Thanks. Dan
Daniel S. Nieto, Ph.D., ACSW
Department of Social Work
453 Waterman Building
The University of Vermont
Burlington, VT 05405-0160
Bitnet address: DNIETO@UVMVM
Telephone numbers (anytime): 802/985-2603 or 802/656-1340
Please feel free to call, write, telephone, etc., should you have any
questions. Thanks again.
Health InfoCom Network News Page 20
Volume 2, Number 27 July 3, 1989
===============================================================================
Articles
===============================================================================
Herpes Simplex Virus
Keywords: HSV/Herpes Simplex Virus/latency/VZV/HIV
--------------------------------------------------
HSV BULLETIN
May 1989
The scale and seriousness of Herpes Simplex Virus disease is increasingly
being recognized. All reports agree that the incidence of HSV is rising and
far from being trivial, infection by HSV can be severely debilitating and in
some instances fatal. However the most disquieting aspect of HSV is the level
of ignorance about the virus among the medical community and the apparent
inability of scientists to direct their attention to finding a reliable cure
for this very painful condition. As is detailed below, a complete cure has
been possible in 22.7% of cases of established, recurrent HSV disease since
1972. This bulletin aims to lift the veil of ignorance surrounding HSV and
thus hasten the effective medical control of Herpes Simplex Virus for the
benefit of millions of HSV sufferers throughout the world.
Herpes Simplex Virus can most appropriately be regarded as a poison: it
is incapable of replication itself but multiplies by taking over normal human
cell replication functions. Therefore the virus may best be perceived not as a
living organism but as a self-perpetuating chemical. The contemporary
explanation for the long-term, recurrent nature of HSV disease is that HSV DNA
is inserted into the genetic DNA core of cells within the human sensory
ganglia surrounding the spine. This results in a latent state during which
time the virus is inactive. Tucked away within the peripheral nervous system,
the virus is able to escape attempts to remove the virus either by the
individual's normal immune functions or by medical treatment. This explanation
of viral activity has been shown to be inadequate since direct reactivation of
HSV from cutaneous (skin) and other tissues has recently been confirmed.
Human cells may most easily be classified as either permissive or non-
permissive for HSV replication: cells which are not permissive for replication
can instead be permissive for HSV latency. Although the virus may most readily
establish its latent state in sensory neuronal cells within the ganglia,
leading to preferential infection of body areas of high sensitivity, wide
variations in the effects of HSV infection can occur due to the particular
virus strain and many other factors.
The most common treatment for herpes viruses is Acyclovir; for Herpes
Zoster (Shingles) it has been given at dosages as high as 5 x 800mg per day
and the drug is safe and highly specific. Acyclovir works by the selective
conversion to an active triphosphate in cells which abundantly express viral
thimidine kinase, characteristic of cells harbouring replicating HSV. The
Acyclovir triphosphate terminates replication by shutting down the cell prior
to the release of large quantities of mature virus.
Notwithstanding, Acyclovir is capable of inhibiting active replication
only and does little or nothing to prevent the establishment and re-
establishment of latency. Virus stock must be depleted from cells as virus
emerges during reactivation and it has to be replaced at some subsequent stage
Health InfoCom Network News Page 21
Volume 2, Number 27 July 3, 1989
in order to perpetuate the disease. There are probably other mechanisms of
viral activity as well as for which Acyclovir is similarly ineffective. In the
laboratory a common food additive, Methyl Gallate, has recently been shown to
be as effective as Acyclovir at inhibiting HSV replication.
At the moment at least two drugs are known to partially inhibit the
direct viral DNA synthesis which gives rise to latency. These are the untried
Buciclovir and the tested and safe ABOB, a biguanide derivative. It is this
latter drug which has been used for many years at the 'Stefan S. Nicolau'
Institute of Virology, Bucharest in conjunction with injections of specific
anti-herpes immunoglobulins to give a 22.7% cure rate for patients having
recurrent HSV disease for two years or more. This accords with the lower
success rates claimed following repeated injections of herpes vaccine, of
which several types exist. None of these treatments are generally available.
It is known that a weak immune function is present within nervous tissue
which remains effective even in the vicinity of the sensory ganglia. However
it has been shown that HSV can establish latency within immune cells
themselves, the very cells which are normally responsible for limiting HSV
disease. This mechanism is directly analogous to the activity of Human
Immunodeficiency Virus.
The method of retrograde axoplasmic transport is an effective means of
targeting sensory neurones and the successful eradication of persistent HSV in
the ganglia of laboratory animals has been achieved. No substance is yet known
to be suitable for administration to humans using this method although one
obvious candidate for injection into the nerve and subsequent axoplasmic
transport to the ganglia, a non-recurrent strain of HSV, has yet to be tried.
Despite the variety of current and prospective treatments for recurrent HSV
disease, even conventional treatment with Acyclovir is sometimes withheld due
to the high cost of the drug.
Hires, Postbus 3707, 1001 AM Amsterdam, The Netherlands
-----------------------------------------------------------------
[More extensive information on HSV is available from the above address: please
enclose the lowest value bank note of your local currency to cover copying and
postage costs].
-----------------------------------------------------------------
Third Party EMAIL address: Bitnet: RAYNOR%RZSIN.SIN.CH Warning, as this is a
drop-off point, EMAIL will be collected over a period of time and forwarded to
Amsterdam. For a faster reply, ordinary "snail" mail is recommended.
-----------------------------------------------------------------
Health InfoCom Network News Page 22
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