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14 | NewScientist | 16 September 2006
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“This might explain why H5N1 cases cluster around bloodlines, and why so few have caught the virus to date” though all had been in close contact with infected poultry (Emerging Infectious Diseases, www.cdc.gov/ncidod/EID/ vol12no10/06-0424.htm). Deaths from H5N1 could become a lot more common if the virus learns to bind better to the protein in most human throats. Then, says de Jong, its fast replication means “we will have to diagnose infection very early, and hit it hard with antivirals”. Fast diagnostic tests are being developed, but they are not yet widely available. ●
From New Scientist, 12 September 1968
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Those who have been driven by fear of lung cancer away from cigarettes, only to hide behind a cloud of pipe or cigar smoke, had better think again. Two doctors have now shown that smoking increases the chance of contracting adenocarcinoma of the kidney by up to 12 times. And the types of smoking most likely to cause this kind of tumour are via cigars and pipes. James Bennington and Frederick Laubscher of Washington state reported recently on the smoking habits of 100 patients with renal adenocarcinoma against 190 matched controls – all the subjects being patients at the hospitals affiliated to the University of Washington between 1951 and 1966. Of the 88 males, 82 (92 per cent) either smoked or chewed tobacco, whereas only 127 out of 170 male controls (75 per cent) used tobacco. The number of women in the trial was too small to be statistically significant but the figures were similar to the male levels. When the type of tobacco smoked (cigarettes, pipe or cigar) was considered, the researchers found that cigarette smokers are 5.1 times as likely to get a renal adenocarcinoma as non-smokers. However, the susceptibility of pipe smokers increased 10.3 times and cigar smokers 12.9 times, suggesting these forms of smoking have higher risks. Those users who only chew their tobacco have a 4.8 times increase. Presumably tobacco chewers are less prone to renal cancer than smokers because certain carcinogens are released from tobacco only when it is burnt. The bad news for chewers, however, is that their risk of carcinoma of the bladder is disproportionately increased.
NT
THE first person to fall ill was a 37-year-old woman who sold fruits and chillies at a market in northern Sumatra, Indonesia, in late April. Days later, her two sons and brother also developed symptoms of H5N1 bird flu, followed by her sister, the sister’s baby, her second brother and his son. As is typical with such clusters of people who have got H5N1, only blood relatives got sick, not spouses or relatives by marriage. Now the first confirmation of how H5N1 kills people also suggests
why these people may be genetically more susceptible to the virus. Menno de Jong of the University of Oxford Research Unit in Ho Chi Minh City, Vietnam, and his colleagues studied tissue samples from 18 people in Vietnam who had H5N1, 13 of whom had died. The dead had heavier loads of the virus in more tissues and showed clearer signs of a “cytokine storm” – a lethal overreaction of the immune system. This confirmed what has previously been observed in animals and isolated cells:
No refuge for smokers
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DEBORA MACKENZIE
THIS WEEK 38 YEARS AGO
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Flu’s killer tactic puts families at risk
that H5N1 is deadly because it replicates very fast and unleashes cytokines. Masses of virus rapidly overwhelm the immune system (Nature Medicine, DOI: 10.1038/nm1477). Surprisingly, the team found large amounts of virus in the victims’ pharynxes. Last March, two separate labs in the US and Netherlands found that while human lungs contain the protein H5N1 binds to, the pharynx normally does not (New Scientist, 25 March, p 21). This could be why H5N1 is relatively hard to catch, they said. “Maybe H5N1-infected patients do have such receptors in the nose and throat due to a different genetic make-up,” de Jong suggests. This might explain why H5N1 cases cluster around bloodlines, and also why so few people have caught the virus to date, despite massive outbreaks in poultry. Avoiding infection is crucial because once you get the virus, you get sick. This week a separate group of scientists in Cambodia, reported finding no evidence that H5N1 can produce cases in which infected people don’t display symptoms. Of the 351 people tested in a village where one man fell ill in 2005, none had antibodies to H5N1, even
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12/9/06 12:32:26 pm