DHMH Daily News Clippings




Radium levels in wells are high (Annapolis Capital)
Ferguson, Mooney still hot about gun bill (Frederick News-Post)
Area suffers effects of nationwide nurse shortage (Hagerstown Herald-Mail)
Results of Blair TB screening expected soon (Montgomery Journal)
State Officials Are Faulted on Anti-Tobacco Programs (New York Times)
Many Makers of Feed Fail to Heed Rules on Mad Cow Disease (New York Times)
U.N. Sees Rise in Mental Disorders in Coming Decades (New York Times)
The Quiet Scourge (New York Times Commentary)
Busy season for hospitals has arrived (Baltimore Sun)
State will provide anti-smoking funds (Baltimore Sun)
Probe detects Pfiesteria in Va. (Baltimore Sun)
Big Tobacco payment cut for 16 states (Baltimore Sun)
Cabinet nominee is linked to big tobacco (Baltimore Sun)
Study measures diets' long-term success (Baltimore Sun)
Assembly puts focus on healing (Baltimore Sun)
Baby dies from Ebola as outbreak nears end (USA Today)
Md. Lawmakers Return To Ceremonial Business (Washington Post)
The High Cost of Selling Blood (Washington Post)
Deaths Tied to 'Date Rape' Drug Kin (Washington Post)
Femara Approved As 1st-Line Drug For Breast Cancer (Washington Post)

By TIM HYLAND, Staff Writer

Annapolis Capital

Wednesday, January 10, 2001

Radium levels exceeded federal contaminant levels in nearly 50 percent of wells tested in Anne Arundel County, according to a new state report.

Prepared by the Maryland Geological Survey, the study found high radium levels in 55 of 113 samples tested in north and central county.

In other areas in the state, just six of 96 wells tested in Prince George's, Baltimore, Harford, Cecil and Kent counties showed similar levels of contamination.

Robert Weber, director of community and environmental health for the county Health Department, said the report released last week underscores what county officials and residents already know.

"Basically, it shows that there is a problem in northern Anne Arundel County," he said. "There's a smaller problem in very small areas of surrounding counties, but we're the lucky ones to have the bulk of the problem."

For the study, 203 wells were sampled in Prince George's, Anne Arundel, Baltimore, Harford, Cecil, Kent and Queen Anne's counties between June and November of 1998.

Eighty percent of the wells tested were private, 15 percent were public and the rest were either institutional, industrial, commercial, recreational or observation wells.

The county's radium problem came to light in 1997, when a U.S. Geological Survey study showed above-normal levels of radium in 22 of 50 wells tested throughout the county. Subsequent studies showed Pasadena, Millersville and Crownsville had the highest levels.

William DeLawder, co-founder of the grass-roots Citizens Against Radium Poisoning, said most people in the Sylvan Shores neighborhood of Pasadena have had their wells tested. After finding radium, many installed water-treatment systems.

Treatment systems cost between $800 and $3,000, Mr. Weber said.

A system has helped reduce radium in his water, but not everyone has been as lucky. Residents are still pushing for public water, Mr. DeLawder said.

"We have one person here that has even drilled a deeper well, and they have a water treatment system, and they're still way high," Mr. DeLawder said. "You can still hear stories spotted around of people having various problems."

Radium is a natural radioactive metal that occurs in groundwater. The U.S. Environmental Protection Agency considers 15 picocuries per liter the maximum safe level of radium in public water.

Health officials estimate that prolonged exposure to radium causes cancer in one in 10,000 people.

The county has tested more than 1,500 wells, and about 63 percent have exceeded the EPA standard. About 600 of those wells were then retested following installation of a treatment system, and only 11 failed to meet the EPA standard.

County Executive Janet S. Owens said the report's findings didn't surprise her.

"I know that (the report) will increase the pressure about public water and increase the fears about development," she said. "Water and sewer always trigger those things."

The county has classified the radium problem as a health concern, not a health emergency.

County Council Chairman Shirley Murphy, D-Pasadena, last month created a task force to study the radium problem in north county wells.

The five-member task force is headed by Johns Hopkins University physics professor Lester Ettlinger, who led a successful fight to prevent Constellation Power Source from trucking anhydrous ammonia to its Brandon Shores Plant.

Published January 10, 2001, The Capital, Annapolis, Md.

Ferguson, Mooney still hot about gun bill

By Douglas Tallman

Frederick News-Post Staff

Thursday, January 11, 2001

ANNAPOLIS — The General Assembly's opening day pomp collided with political circumstances Wednesday, as Frederick County's two state senators led a protest against Sen. Thomas V. Mike Miller's election to the upper chamber's presidency.

Their nay votes — overwhelmed by yeas — came from the lingering resentment over last year's gun safety bill that critics claim has turned into a gun ban.

The bill had been mired in the Senate's conservative Judicial Proceedings Committee, so the Prince George's County Democrat employed a little-used Senate rule to yank the bill out of committee. Conservatives protested the maneuver, but the full Senate voted 26-21 in favor of the bill.

Sen. Timothy Ferguson, R-Frederick/Carroll, and Sen. Alex Mooney, R-Frederick/Washington, both sit on Judicial Proceedings.

Mr. Ferguson called Mr. Miller's maneuver "a protocol disruption."

"Our committee was not allowed to do their work," Mr. Ferguson said.

The palace revolt secured only one other nay vote, Sen. Andrew P. Harris of Baltimore County. Four other Senate Republicans — J. Robert Hooper of Harford, Nancy Jacobs of Harford, Christopher McCabe of Howard and Larry Haines of Carroll — abstained.

The seven remaining Republicans joined with 32 Democrats to easily elect Mr. Miller to his 15th year as the "permanent presiding officer" of the Maryland Senate. Mr. Miller also abstained from voting.

Across the hall in the House of Delegates, far less intrigue marked the beginning of that chamber's legislative session.

Delegate Casper Taylor, D-Allegany, was voted House Speaker and Delegate Thomas Dewberry, D-Baltimore County, is speaker pro tem.

In his address to the delegates, Mr. Taylor spoke of the state's booming economy.

"The golden path of prosperity is what our parents and grandparents worked and fought and sacrificed so much for," he said.

Gov. Parris Glendening and Lt. Gov. Kathleen Kennedy Townsend visited both chambers to welcome in the new session. In his remarks, Mr. Glendening held up what looked to be a rolled up map — a proposal for new district boundaries for lawmakers that would be delivered after they pass his legislative agenda.

The House and Senate also introduced a series of Washington officials, former lawmakers and the county executives from the state's largest counties.

Officials from Frederick County, however, weren't among the invited dignitaries, which disturbed Commissioner Ilona Hogan. Mrs. Hogan, Frederick Mayor Jim Grimes and aldermen Blaine Young and William Hall sat in the upper galleries overlooking the proceedings on the floor below.

"I'm down here because I think it's important that we show respect and support for the different branches of government," she said. She sat in seats reserved for her by Delegate Louise Snodgrass, R-Frederick/Washington.

But she said she was "disturbed" Commissioners President David Gray also was not invited.

Mr. Miller's nomination came from three fellow senators: Majority Leader Clarence W. Blount, D-Baltimore city, and Baltimore County Democrats Barbara Hoffman and Thomas Bromwell.

Mr. Bromwell, only weeks ago, was trying to wring the Senate presidency from Mr. Miller after the Prince George's County legislator criticized one of Mr. Bromwell's friends.

After his election, Mr. Miller talked of the partisanship infecting the U.S. Congress that was ready to spread to state capitals.

He turned an eye toward the Senate's electronic tally board that records "yea" votes in green and "nay" votes in red.

"I don't mind these three red votes. I don't mind them at all," he said.

Mr. Ferguson rose to explain his vote, Mr. Miller asked him to wait so "our dignitaries who don't want to hear what you have to say can leave."

Later, when he continued, Mr. Ferguson said he thought well of Mr. Miller and acknowledged him as the Senate's leader.

He said he cast the "red vote" because of a "protocol disruption" over the Responsible Gun Safety Act of 2000, Mr. Glendening's landmark gun safety legislation.

Part of that law requires gun manufacturers to provide each handgun with a cartridge fired from that gun. At the time of sale, the cartridge is to be sent to the Maryland State Police, where it will become part of a statewide "ballistics fingerprinting" database.

Gun manufacturers have complained that the provision is unworkable. Critics fear the gun makers will refrain from selling their guns in Maryland, creating a de facto gun ban.

"It was a bad bill and a bad law," Mr. Ferguson said.

Mr. Mooney also rose to explain his vote, complaining that the procedure used to pull the bill from Judicial Proceedings violated the Senate's own rules.

"The minority party has a right to be heard," he said.

After adjournment, Mr. Miller said he didn't mind the criticism, even though he disagreed.

The gun bill "wasn't a Republican-Democrat issue. It was a conservative-progressive issue," he said. By forcing the bill out of committee, he was "allowing the will of the people to be heard," he said.

And Mr. Mooney's claim that Senate rules were violated: "He's wrong. He's just totally wrong."

In addition to electing Mr. Miller, the Senate chose Ida Ruben, the Montgomery County Democrat with the distinctive beehive hairdo, as the Senate's president pro tem.

Area suffers effects of nationwide nurse shortage

By STACEY DANZUSO / Staff Writer, Chambersburg

Hagerstown Herald-Mail

Thursday, January 11, 2001

CHAMBERSBURG, Pa. - A nursing shortage has forced Chambersburg Hospital to temporarily shut down one of its operating rooms and postpone some elective surgeries this month, officials said Tuesday.

Personnel at other hospitals in the Tri-State area, including Washington County Hospital in Hagerstown and City Hospital in Martinsburg, W.Va., said they, too, face nursing shortages.

A series of events triggered the Chambersburg move, including an increase in the number of patients last year, a nationwide shortage of registered nurses and unexpected leaves of absence taken by several of the hospital's operating room nurses, said David Carlson, vice president of medical affairs.

Hospital officials decided to close one of the hospital's seven operating rooms last week but hope to have sufficient staff to reopen it within the next few weeks, Carlson said.

The temporary closure has prompted surgeons to postpone between three and 10 elective procedures a day, including cataract and knee surgeries.

The health-care industry began to take note of the nursing shortage about a year ago, Carlson said.

"There is a huge demand at the national and local level. I can't imagine any agency not affected," he said. "We're all competing for a limited employment pool."

With a half-dozen hospitals in the Tri-State area vying for nurses, it's becoming increasingly difficult to attract new nurses, Carlson said.

"As a result, we found ourselves in a position to close one of seven operating rooms. Those procedures considered to be elective are scheduled further out," he said. He stressed that the elective procedures have not been canceled, and that staff is available for all urgent and emergency procedures.

"It's a short-term, acute problem," he said.

Carlson was optimistic that staff members who were on leave would return in the next few weeks and the hospital could then reopen the seventh operating room. He also was planning to hire more operating room nurses and surgical technicians as soon as possible to staff the eighth operating room, which is currently not used.

On average, it takes about 90 days to fill an operating room nurse position or surgical technician position.

Because operating room nurses go through an additional six to 12 months of training, Carlson said the hospital couldn't borrow nurses from other specialties to fill the operating room vacancies.

Instead, the hospital has had to pull in nurses on administrative duty that had prior operating room experience, Carlson said.

The shortage at Chambersburg Hospital has not affected its affiliate, Waynesboro Hospital.

The staffs at the two hospitals work independently, and while Waynesboro Hospital has been affected by the general nursing shortage, it has not created problem in the operating room.

"It's a regional situation. Everyone is feeling the pinch," Carlson said.

Officials at City Hospital in Martinsburg and at Washington County Hospital in Hagerstown said they've had trouble staffing nursing positions.

City Hospital has had an overall vacancy rate of 9 percent in nursing services, including registered nurses, licensed practitioners and unit secretaries, in the past few months.

"Whenever any position is vacant, it falls to someone to pick up that work," said Kathleen Wotring, chief nursing officer at City Hospital.

At times the shortage has spiked, but Wotring said that compared to other places the hospital is doing well, using nurses from a network of temporary nurses, including traveling nurses from as far away as Florida, who come on 13-week assignments.

Despite her best efforts, Wotring said some shifts don't have all of the staff called for in the hospital's master staffing plans.

"That doesn't mean our patients are in danger. I would curtail services before trying to provide care that wasn't safe," she said.

Wotring said the shortage is due to the number of career opportunities now available to women, who largely made up the nursing field in the past.

Enrollment at nursing schools nationwide has been dropping for the last five years and shows no sign of turning around, she said.

That, coupled with a demand for more nurses in the private sector - doctors' offices and home health agencies - has created the problem.

"Most of those places don't require you to work nights and weekends," she said.

The problem has also hit Washington County Hospital, which has had to cope with a shortage of nurses over the last several months, said Maureen Theriault, a hospital spokeswoman.

The hospital has a standing ad on its Web site and offers sign-on and recruitment bonuses, but so far, it is faring better than most Maryland hospitals.

"In terms of the overall vacancy rate in Maryland hospitals, we are one of the ones with the lowest vacancy rates," Theriault said.

She said nurse managers are constantly evaluating their staffing resources to use them in the most effective way.

So far, the hospital has not had to take any long-term or drastic measures, but on occasion it has had to postpone some elective surgeries, she said.

"We are also trying to make sure patients in monitored beds are moved to one of the floors in a timely fashion and patients ready for discharge are discharged as efficiently as we can." she said.

Recent quarantines for the flu at four area nursing homes have added to the problem.

"Patients who are to go back to the nursing homes from the hospitals, or those who came to the hospital and need nursing home care, have to wait longer," Theriault said.

Theriault said Wednesday she did not have the names of the four nursing homes.

Results of Blair TB screening expected soon

By JANELLE COWGILL

Montgomery Journal staff writer

Thursday, January 11, 2001

County health officials today were to begin reviewing results from tuberculosis screening tests of nearly 100 students and staff at Montgomery Blair High School in Silver Spring.

Kate Harrison, a Montgomery County Public Schools spokeswoman, said a Blair student who was diagnosed with tuberculosis in October no longer is infectious.

County spokeswoman Donna Bigler said the student had been diagnosed in another jurisdiction, although she declined to provide specifics for fear that the information would enable others to identify the student.

Montgomery County health officials learned the student was contagious immediately before students were released for winter break last month. Schools officials told students and staff of the problem when they returned to school last week.

All students and teachers who were in class with the student - 97 in all - were tested for the illness since they had extended contact with him, said Bigler.

On Tuesday and yesterday, health officials administered skin tests to the students and staff members. Health officials will see them again today and tomorrow to determine whether they had any reaction to the test.

If the person doesn't show a reaction, he or she will be given a clearance card indicating the test was negative and follow-up tests won't be necessary. However, if there is a reaction, he or she will have to have a chest X-ray.

Health officials said a positive reaction to the skin test doesn't necessarily mean the person has tuberculosis, only that he or she has been exposed to it.

Health officials say that for every active tuberculosis case, about 1,000 people test positive on skin tests but don't have an active case of the illness.

For those who are infected, an antibiotic usually can be prescribed that reduces the chances of contracting the disease by about 95 percent.

Tuberculosis is caused by slow-growing bacteria spread in the air between people. Because the bacteria grow so slowly, those who are infected don't show symptoms for months, or even years.

The disease can affect any organ, according to medical literature, but for humans the lungs generally are involved and also can cause infection in other organs.

Blair Principal Phillip Gainous and Carol Garvey, a physician who serves as Montgomery County's health officer, sent a letter home with Montgomery Blair students a week ago that asked for permission to test students for tuberculosis.

``We want to assure you that the affected student is not infectious at this time and there is no danger to any students and staff," the letter to parents and guardians said. ``The infectious period occurred before the tuberculosis was diagnosed and before medication was begun."

State Officials Are Faulted on Anti-Tobacco Programs

By GREG WINTER

New York Times

Thursday, January 11, 2001

Only six states spend even the minimum amount on programs to prevent and stop smoking that is

recommended by the Centers for Dsease Control and Prevention, the Campaign for Tobacco-Free Kids, an advocacy group in Washington, says in a report to be released today.

A majority of states spend less than half of what the centers advises, the report says, while at least two, Michigan and North Dakota, support no antismoking programs at all with their money from a $206 billion national tobacco settlement.

The surgeon general has sharply criticized state lawmakers for neglecting prevention and spending too much on programs unrelated to smoking.

"We're going to pay sooner or later if we allow children to start smoking," said the surgeon general, Dr. David Satcher. "The tobacco settlement funds represent an opportunity that we've never had before to save lives, and we're missing it."

Dr. Satcher and numerous tobacco opponents worry that as the economy slows, lawmakers may use settlement money to offset reductions in tax revenue. Montana and Maine have already begun cutting back on efforts to prevent smoking and applying the money elsewhere. Virginia may use part of its settlement money to help phase out a property tax on cars.

"This is definitely something we're going to see played out through all of the states as the economic downturn affects state revenues," said Lee Dixon, health policy director for the National Conference of State Legislatures.

Under the 1998 agreement with tobacco companies, states are free to spend their settlement money as they see fit. Most use it to offset Medicaid expenses, support children's programs or improve education, but the payments have also gone to run boot camps for juvenile offenders in Alabama, build levees in North Dakota and provide tax cuts in Illinois and Connecticut.

Over all, less than 10 percent of the nearly $8.2 billion in settlement money allocated by states in fiscal years 2000 and 2001 has gone to combat smoking, less than half of the percentage that the disease control centers recommends.

Dr. Satcher predicted that if all states had aggressive antismoking programs like those in California and Massachusetts, smoking rates could be halved in a decade.

Cigarette sales have been falling by 1 percent to 2 percent a year since the mid-1990's and dropped sharply in 1999 when tobacco companies raised prices to an average of $3 a pack. But sales have since returned to their old rate of decline.

The centers estimates the cost of treating tobacco-related illnesses at more than $50 billion a year, and states bear at least $6 billion of that in Medicaid expenses alone.

A 1999 study by M.I.T. found that antismoking campaigns cut health care costs in Massachusetts by $85 million a year.

But in some states, money for to fight smoking is increasingly scarce.

The National Conference of State Legislatures reports that state revenues are increasing 3.5 percent this year on average, down from the 5 percent growth many states expected just months ago and the smallest increase in at least three years.

Many Makers of Feed Fail to Heed Rules on Mad Cow Disease

By SANDRA BLAKESLEE

New York Times

Thursday, January 11, 2001

Large numbers of companies involved in manufacturing animal feed are not complying with

regulations meant to prevent the emergence and spread of mad cow disease in the United States,

the Food and Drug Administration said yesterday.

The widespread failure of companies to follow the regulations, adopted in August 1997, does not mean that the American food supply is unsafe, Dr. Stephen Sundlof, director of the Center for Veterinary Medicine at the F.D.A., said in an interview.

But much more needs to be done to ensure that mad cow disease does not arise in this country, Dr. Sundlof said.

The regulations state that feed manufacturers and companies that render slaughtered animals into useful products generally may not feed mammals to cud-chewing animals, or ruminants, which can carry mad cow disease.

All products that contain rendered cattle or sheep must have a label that says, "Do not feed to ruminants," Dr. Sundlof said. Manufacturers must also have a system to prevent ruminant products from being commingled with other rendered material like that from chicken, fish or pork. Finally, all companies must keep records of where their products originated and where they were sold.

Under the regulations, F.D.A. district offices and state veterinary offices were required to inspect all rendering plants and feed mills to make sure companies complied.

But results issued yesterday demonstrate that more than three years later, different segments of the feed industry show varying levels of compliance.

Among 180 large companies that render cattle and another ruminant, sheep, nearly a quarter were not properly labeling their products and did not have a system to prevent commingling, the F.D.A. said. And among 347 F.D.A.-licensed feed mills that handle ruminant materials — these tend to be large operators that mix drugs into their products — 20 percent were not using labels with the required caution statement, and 25 percent did not have a system to prevent commingling.

Then there are some 6,000 to 8,000 feed mills so small they do not require F.D.A. licenses. They are nonetheless subject to the regulations, and of 1,593 small feed producers that handle ruminant material and have been inspected, 40 percent were not using approved labels and 25 percent had no system in place to prevent commingling.

On the other hand, fewer than 10 percent of companies, big and small, were failing to comply with the record-keeping regulations.

The American Feed Industry Association in Arlington, Va., did not return phone calls seeking

comment.

U.N. Sees Rise in Mental Disorders in Coming Decades

By REUTERS

New York Times

Thursday, January 11, 2001

GENEVA - Mental and neurological disorders--ranging from depression to Alzheimer's and epilepsy--strike 400 million people globally and are set to surge in the next two decades, the World Health Organisation (WHO) said on Tuesday.

The United Nations health agency predicted that by 2020, depression would jump to be the second greatest cause of death and disability worldwide, following ischemic heart disease.

WHO officials attributed the projected rise in depression to factors including more stressful lifestyles, poverty and violence. Alzheimer's disease, a debilitating dementia that hits the elderly, is expected to increase as people live longer.

They spoke at a news briefing to launch WHO's 2001 campaign aimed at removing myths and stigmas linked to such disorders, whose slogan is ``Stop exclusion--Dare to care''.

``This (campaign) is overdue, given that mental health is a major cause of disability, family and

community distress and loss of production,'' said WHO's Dr. Derek Yach.

Dr. Benedetto Saraceno, director of WHO's department of mental health and substance dependence, said: ``Mental health disorders, neurological diseases is a major public health concern worldwide. There is a common myth that mental health problems are those of rich, industrialised countries, a luxury.''

``But mental and neurological problems are equally important in rich and poor countries,'' he added.

400 MILLION SUFFER WORLDWIDE

Some 400 million people today suffer from mental and neurological disorders worldwide, according to Saraceno.

``Unipolar major depression is today considered fifth in the ranking of major causes of disability and it is expected to jump to second place in 2020,'' he said.

At present, depression is the fifth leading cause of death and disability, while ischemic heart disease trails in sixth place, according to the Geneva-based WHO.

The table is currently topped by acute lower respiratory infections, according to the WHO, which says infectious diseases are generally expected to fall.

Depression, often genetic, hits roughly twice as many women as men, according to WHO experts.

The Americas and Western Pacific regions have the most victims of depression, with the lowest rates in Africa, according to Saraceno.

``Surveys in Brazil, Zimbabwe, India and Chile show the more impoverishment--measured by hunger, level of debt and education--the higher the prevalence of common mental disorders,'' said Yach, a South African.

Mental and neurological disorders represent 11% of the ''global burden of disease'', a figure based on mortality and disability, according to Saraceno. The figure is expected to represent 14% in 2020, he said. ``The good news is that mental health treatment does not require very expensive infrastructure.''

``We know that 70 percent of those suffering from major depression can fully recover if properly treated,'' he added. ''We can expect a decrease in suicides if we are properly treating depressed people.''

Globally, there are one million suicides a year out of a total of 10 million attempts, he added. The top 10 countries for suicide are composed of all former Soviet Union states, led by Russia, where many are reeling in economic and social upheaval.

Schizophrenia, a chronic disorder, affects 45 million people worldwide, with about half of the victims achieving full ''social recovery'', according to Saraceno.

He praised India and China for their programmes for treating and supporting schizophrenic patients, combing use of generic psychotropic drugs and human resources.

``Different diseases are prominent in different regions, with one exception. Schizophrenia is ubiquitous--you will find the same rate of schizophrenia in Los Angeles and central Africa, probably because there is a very strong genetic component.''

The Quiet Scourge

By BOB HERBERT

New York Times Commentary

Thursday, January 11, 2001

The AIDS virus is surging like a prairie fire through black communities in the United States.

The epidemic is not getting anything like the attention it deserves. The Centers for Disease Control now believes that one in every 50 black American men is infected with H.I.V. That is an astonishing statistic.

AIDS is the leading cause of death for African-Americans between the ages of 25 and 44. While blacks are just 13 percent of the U.S. population, more than half of all new H.I.V. infections occur among blacks. Blacks are 10 times more likely than whites to be diagnosed with AIDS, and 10 times more likely to die from it.

This would be a good time for black Americans to say, enough.

The disease is concentrated in inner-city neighborhoods, where AIDS orphans have become ubiquitous. The suffering caused by the disease is all but unbearable. In some cases, entire families are being wiped out. You can put away the notion that AIDS is a disease that primarily affects gay white males. That story has changed. Black women, for example, are becoming infected at a frightening rate. They account for 64 percent of all new infections among women in the U.S.

One in every 160 black women is believed to be infected with H.I.V. By comparison, one in 250 white men is infected, and one in 3,000 white women.

Alarms should be clanging from coast to coast. The idea that black Americans would submit quietly to this level of devastation from AIDS — as if no lessons had been learned from the pandemic in Africa — is repellent.

"It's an overwhelming problem in the African-American community," said Dr. Helene Gayle, who heads the H.I.V. programs at the Centers for Disease Control. "It has continued to increase along a trajectory that we had talked about for a long time."

There are myriad factors contributing to the spread of H.I.V. and AIDS among blacks. Information about the threat of AIDS has not been disseminated widely or effectively enough, particularly among youngsters who feel they are invulnerable. Joe Pressley, an official with the New York AIDS Coalition, told me about a 15- year-old girl who said: "Don't tell me nothin' about no AIDS because that won't impact me. And if I was to get it, all I'd have to do is take a pill in the morning and I'll be O.K."

Intravenous drug users spread the virus among themselves by sharing needles, and pass it on to their partners through sexual contact. Other types of drug use can lead to poor judgment about sexual behavior, including the practice of trading sex for crack and other substances.

Dr. Gayle mentioned the higher rates of other sexually transmitted diseases among blacks and noted that they help fuel the spread of AIDS. And the extremely high rates of H.I.V. infection among black men — drug users and men who have sex with both men and women — have made black women especially vulnerable to infection from heterosexual contact.

Many blacks are poor and lack access not only to health care information and preventive services in general, but even to necessary treatment once they fall ill.

There was widespread denial in the black community for years about the spread of AIDS among African- Americans, in part because of the powerful stigmas attached to AIDS, homosexuality and IV drug use. Enormous numbers of blacks with the virus suffered in silence and shame, unable to tell their families or even their ministers.

At the same time, the attention of the wider public and the bulk of the services related to H.I.V. and AIDS were geared to the community of white gay men, which in the beginning was the epicenter of the problem.

Some voices are now being raised in opposition to this raging epidemic in the black community. The consciousness of the black clergy is slowly being elevated. Politicians are beginning to speak out. But voices here and there are not enough. Nothing less than a mighty chorus is needed to cope with this overwhelming tragedy — a chorus comparable in its seriousness of purpose to the civil rights movement.

Julian Bond, chairman of the N.A.A.C.P., has been trying to get out the following, absolutely crucial message: "This has become a black disease. Stop thinking about this as something that happens to somebody else. Because it happens to us."

Busy season for hospitals has arrived

Emergency rooms across metro area call 'yellow alerts'; Patients exceed resources; Weather,

economics share responsibility for national trend

By Jonathan Bor

Baltimore Sun Staff

Thursday, January 11, 2001

With the flu season just getting under way, hospital emergency rooms throughout metropolitan Baltimore have been declaring "yellow alerts" this week -- meaning they are too busy to take additional patients.

Though the number fluctuates from hour to hour, seven of the region's 21 hospitals were asking ambulances to take patients elsewhere by late afternoon yesterday.

A day earlier, 17 said they were treating all the patients they could handle.

"It's very busy," said Dr. Brian Browne, director of emergency medicine at the University of Maryland Medical Center. "In fact, it's busier than ever."

Echoing others in the field, Browne said the crush of patients is not the product of a sudden upsurge in influenza or any other disease.

Rather, Browne said, this is the continuation of a trend -- part economic, part seasonal illness -- being felt by emergency rooms across the country.

Patients are relying more on emergency rooms for their primary care, a condition made worse when winter brings the usual increase in respiratory infections, asthma attacks and broken bones from slips and falls.

Also, emergency departments are having trouble moving patients to hospital floors -- creating bottlenecks in waiting rooms.

In some cases, this is because cost-conscious hospitals have reduced the number of beds in inpatient units; many are also having trouble hiring enough nurses.

"The emergency rooms are and emergency medical systems are becoming increasingly crowded," said Dr. Robert Bass, executive director of the Maryland Institute for Emergency Medical Services Systems. "This is happening all over the country."

The flu season has been relatively mild and late in getting started. The state has recorded 17 cases of laboratory-confirmed influenza, compared with 94 at the corresponding time last year, according to Dr. David Blythe, an epidemiologist with the state Department of Health and Mental Hygiene

Although just a snapshot, a look around the University of Maryland Medical Center's emergency department shows what hospitals are facing.

In the "acute" portion of the emergency room, where patients with a range of illnesses are taken, doctors were treating three patients with chest pain, one with lightheadedness, a few with shortness of breath and several who were running fevers.

Hooked to monitors and intravenous tubes, these were among the patients filling curtained-off beds on either side of a main corridor.

Meanwhile, a patient in the midst of an asthma attack was sitting in an "asthma chair" -- such patients are uncomfortable lying down -- while three having psychiatric episodes were seated in another area not in plain view.

"We're busy, but not unusually stressed," said Dr. David Rorison, an emergency room physician. "It's not a crisis."

Last year, the hospital treated 40,000 patients -- a 10 percent increase over the previous year, Browne said.

He said patients were waiting about two hours to see a doctor yesterday. It could take another two hours to get treated and discharged.

Though the West Baltimore hospital was on "yellow alert" yesterday, this is not an unusual occurrence. It declares itself too busy to accept new patients at various points throughout the year, but more often in the winter.

When a hospital declares a "yellow alert," the state's emergency medical system asks ambulances to take all but the sickest patients to the next closest hospital not on alert.

Under state law, all hospitals must accept patients who walk in on their own. Also, ambulances are expected to take critically ill patients -- such as those in the midst of a heart attack -- to the closest emergency room, regardless of patient load.

In Towson, the Greater Baltimore Medical Center placed extra nurses on duty to cope with its busy emergency room.

Dr. John Wogan, chief of emergency medicine, said the hospital has seen a wide range of illnesses, including flu, asthma, pneumonia and flare-ups of emphysema.

"Because it's slipperier out there, you also see more orthopedic cases," he said.

Overcrowding has afflicted not only the largest hospitals, such as Johns Hopkins in East Baltimore, but also small ones in Cumberland in Western Maryland and Berlin on the Eastern Shore, according to Bass.

Originally published Jan 11 2001

State will provide anti-smoking funds

Tobacco settlement money is in escrow because of dispute

By M. Dion Thompson

Baltimore Sun Staff

Thursday, January 11, 2001

Gov. Parris N. Glendening told key legislators yesterday that he will provide taxpayer money to replace more than $40 million for cancer research and other efforts aimed at reducing the number of smokers in the state.

The money should have been available through Maryland's portion of the national tobacco settlement, but the administration has been holding the money in escrow because of the state's dispute with lawyer Peter G. Angelos over his fees.

The state will provide $16 million for cancer research and other programs that had been denied money pending resolution of the dispute. That includes $12 million for the University of Maryland Medical System and Johns Hopkins Hospital.

The governor said he will make $26 million more available in the fiscal 2002 budget that he will announce next week.

Glendening's announcement drew a quick and positive response from legislators. "I was thrilled," said Sen. Barbara A. Hoffman, chairman of the Budget and Taxation Committee.

In September, the administration announced that it would keep $21 million of the tobacco settlement money in escrow in case a judge or appeals board ruled that Angelos was entitled to a quarter of the $4.2 billion Maryland expects to get from tobacco companies over the next 25 years.

In the coming year, $53 million will be put in escrow. Although the governor is making nearly half that amount available, some programs that had expected tobacco settlement money won't be fully funded.

Michael Morrill, the governor's spokesman, said many of the affected programs are just getting started and will not be harmed by the cuts. He said many other programs will get what they were promised.

"Everybody who got a deferral [in this year's budget] is going to get that money in 2002," he said. "We think that this is a very balanced approach."

Both Hoffman and Del. Howard P. Rawlings, chairman of the House Appropriations Committee, said a solution had to be found so the state could make good on the promises made to Hopkins, the University of Maryland and various community organizations.

"I think we made it abundantly clear that if the governor didn't fix it, we were going to fix it. And we had the support of our colleagues in the General Assembly," Rawlings said. "I think the governor realized the harm that he was inflicting on Hopkins and the University of Maryland, and he decided to solve the problem."

The legislators were concerned that Hopkins and the University of Maryland had been forced to delay hiring and research projects. Yesterday, Dr. Martin Abelhoff, director of the Johns Hopkins Comprehensive Cancer Center, said he was "absolutely delighted" that money had become available to help the center move forward with its programs.

Dr. Stephen C. Schimpff, chief executive officer of the University of Maryland Medical Center, said he too was pleased that the governor found the money.

"He was always clear that this was something that he wanted to fund," Schimpff said. "The governor's action today is really going to accelerate important research which will improve the care of patients in Maryland.

Originally published Jan 11 2001

Probe detects Pfiesteria in Va.

Researchers at Institute of Marine Science find diagnostic procedure

Ascribe News Service

Baltimore Sun

Thursday, January 11, 2001

GLOUCESTER POINT, Va. - Virginia Institute of Marine Science scientists Kimberly Reece and Nancy Stokes have developed molecular diagnostic tools to detect Pfiesteria piscicida and related organisms in water samples.

The tools were developed using funds for Pfiesteria research provided to VIMS by the Virginia General Assembly and a grant from Environmental Protection Agency. The researchers used the tools to look for Pfiesteria in water samples collected during September and October by the Department of Environmental Quality.

Results showed that Pfiesteria piscicida and related organisms, were present at several locations in Virginia waters. Pfiesteria piscicida was found at 11 sites, including Pocomoke River, Occohannock Creek and Onancock Creek on the Eastern Shore and in the Great Wicomico, York and Coan Rivers.

'Not surprised'

"We were not surprised to find these organisms." said Reece. "Because Pfiesteria has been found in Maryland waters, it is not unexpected that we've now found it in Virginia waters - especially because of this sophisticated new test which is more sensitive than tests we used in the past."

Eugene Burreson, Director for Research and Advisory Services at VIMS said, "This is only one component of a large VIMS Pfiesteria research program funded by the General Assembly. The results are important for Virginia because these diagnostic tools will be used routinely next year in the Pfiesteria monitoring programs that are coordinated by DEQ and the health studies conducted by Virginia Commonwealth University and the Virginia Department of Health."

DNA detectors

Reece and Stokes developed primers for the polymerase chain reaction and DNA probes that specifically detect either Pfiesteria piscicida. Primers and probes are small pieces of DNA that are identified as being unique to a specific organism. Using these molecular tools, researchers can detect the DNA of targeted organisms extracted from water samples.

Reece's lab employed polymerase probes to detect the DNA of Pfiesteria. The identity of each organism was confirmed through DNA fingerprinting and DNA sequencing.

These tests detect the presence of DNA from Pfiesteria piscicida. Reece emphasizes that the tests do not determine absolute abundance or toxicity of these organisms. There is no evidence, from fish kills or health reports, that the organisms found are expressing toxicity.

Dr. Burreson said, "We are now in the process of expanding these techniques and acquiring equipment that will also enable us to measure the abundance of these organisms in water samples. Molecular diagnostics such as these, also enhance our other studies by providing new tools to examine the life cycle of Pfiesteria and other aspects of its biology."

Originally published Jan 11 2001

Big Tobacco payment cut for 16 states

$197 million withheld after deadline is missed

Associated Press

Baltimore Sun

Thursday, January 11, 2001

HARRISBURG, Pa. - Sixteen of the 46 states that settled with the tobacco industry two years ago have seen their most recent payments reduced by almost $200 million, in part because they failed to enact a piece of legislation in time.

The December payouts to both California and New York were $44 million less than the $247 million they had each expected to get, while Pennsylvania received $111 million instead of $130 million.

In all, about $197 million was withheld from the 16 states - Maryland was not among them - and five U.S. territories.

The settlement with Big Tobacco totals about $206 billion over 25 years. The twice-a-year payouts to the states are determined by an independent auditor.

Some previous payments have been lower than projected because of slowdown in cigarette sales and inflation.

The latest payments were cut because the states and territories failed to pass a law by June 1999 designed to protect the companies from losing too much market share to other manufacturers.

The industry feared that the nonparticipating companies might gain an advantage because they would not be restricted by the settlement's ban on billboard advertising and other marketing tactics, such as cartoon images like Joe Camel.

Under the law that the states were expected to enact, nonparticipating manufacturers were given the choice of signing onto the settlement or making annual payments into an escrow account equal to the market share loss.

All 46 states have since enacted the law and will get their full regular payments in the future.

The states are considering suing to shake the money loose with the help of the National Association of Attorneys General.

"We're confident we'll prevail," said Sean Connolly, a spokesman for Pennsylvania Attorney General Mike Fisher.

The other affected states, according to group of attorneys general, are Alabama, Arizona, Connecticut, Delaware, Hawaii, Kentucky, Massachusetts, Michigan, North Carolina, Oregon, Vermont, Wisconsin and Wyoming.

The U.S. territories are American Samoa, Guam, Northern Mariana Islands, Puerto Rico and the U.S. Virgin Islands.

Originally published Jan 11 2001

Cabinet nominee is linked to big tobacco

Companies funded trips abroad by Thompson

Associated Press

Baltimore Sun

Thursday, January 11, 2001

WASHINGTON - President-elect George W. Bush's choice to head the Department of Health and Human Services has visited three continents at the expense of a major tobacco company, including a trip to Australia that involved a scuba diving excursion with a tobacco lobbyist.

Wisconsin Gov. Tommy Thompson, Bush's choice for the post, also has received tens of thousands of dollars in campaign contributions from tobacco interests and has been criticized for delaying Wisconsin's entry into the lawsuit against tobacco companies.

After that lawsuit was settled, Thompson proposed spending only $5 million of Wisconsin's $170-million-a-year share on smoking prevention. He ultimately signed a bill that gave much more money for the effort.

Nevertheless, Alicia Peterson, a spokeswoman for the Bush transition team, said Thompson "has a record of opposing youth access to tobacco and tobacco products." Others note Thompson signed four different tobacco tax increases in his state and backed a ban on smoking in the state capitol.

Peterson said Bush selected the Wisconsin governor for HHS because he is "a national leader in welfare reform and health care reform."

Thompson's well-documented links to the tobacco industry, particularly Philip Morris, have caused little outcry among public health advocates.

"His record in Wisconsin raises concerns about his commitment to reducing the toll from tobacco," said Bill Corr, executive vice president of the Campaign for Tobacco Free Kids. But, he added, "now that he has been nominated to lead the nation's top health agency, we're hopeful he will be willing to work with the public health community to address tobacco usage in all its forms."

Among the Thompson-tobacco industry links cited by anti-tobacco activists:

During the 1990s, Thompson traveled to England, Africa and Australia on trips arranged by the National Governors Association and substantially funded by Philip Morris through three nonprofit groups created to promote free trade. He said at the time he wasn't aware of the company's backing and might not have gone if he had.

Between 1993 and 2000, Thompson collected nearly $100,000 in campaign contributions from executives and political action committees of major tobacco companies and their subsidiaries, according to the Wisconsin Democracy Campaign.

As governor, Thompson vetoed legislation that would have let cities impose stricter rules on tobacco than exist in state law.

Thompson's supporters argue that Philip Morris, through its nontobacco food and beer subsidiaries, is Wisconsin's largest employer and he had no choice but to support the company.

Originally published Jan 11 2001

Study measures diets' long-term success

Many popular plans fail to keep weight off, it says

Associated Press

Baltimore Sun

Thursday, January 11, 2001

WASHINGTON - Most popular diets help people drop pounds initially but only traditional moderate-fat, high-carbohydrate regimens seem to keep the weight off, the government concludes.

The Agriculture Department study found that any diet that limits food to about 1,500 calories per day produces short-term weight loss, but those diets do little to help a dieter lower cholesterol and blood pressure levels.

"In sum, all popular diets, as well as diets recommended by governmental and nongovernmental organizations, result in weight loss. However, it is important to note that weight loss is not the same as weight maintenance," the USDA report said.

The study is to be released today at a meeting at which the department will consider ideas for a long-term study of diet programs. The study will be conducted by the department's network of human nutrition laboratories.

The report is the first from a continuing review of various popular diet programs.

Agriculture Secretary Dan Glickman has said it is time for the government to help the public sort out the facts about popular diets.

The report "does validate our need to proceed" with a long-term study, a USDA spokeswoman said.

Those programs that have put more demands on dieters - such as those recommended by the American Heart Association and Weight Watchers - have the best scientific evidence to back up their success rates and health claims.

They recommend consuming no more than 30 percent of calories as fat, limiting protein to about 20 percent and consuming more complex carbohydrates - fruits, vegetables and grains - to help satisfy hunger with fewer calories.

They are the most nutritionally adequate and showed some of the best improvements in blood levels of the most dangerous cholesterol and blood fats and in blood sugar control, the study found.

A spokeswoman for Robert Atkins, a promoter of a popular high-fat, low-carbohydrate diet, agreed that more research is needed but said the government is biased against programs such as Atkins'.

Originally published Jan 11 2001

Assembly puts focus on healing

But 7 in GOP protest re-election of Miller as Senate president

By Jeff Barker

Baltimore Sun Staff

Thursday, January 11, 2001

The 415th Maryland General Assembly session opened yesterday with pomp, industry-sponsored receptions and the frequently expressed hope that 188 legislators can overcome recent unrest in their ranks and budget disagreements with Gov. Parris N. Glendening.

Monsignor Paul M. Dudziak, pastor of a Calvert County church, selected an apt theme for the prayer to begin business in the elegant Senate chamber, where many of the 47 members were accompanied by spouses and wriggling children.

He asked that the lawmakers be confronted with "mountains too high to climb, and chasms too wide to bridge, so that we learn to find our strength in you."

Chasms, indeed.

The kickoff of the 90-day legislative sprint found leading players eager - perhaps overeager in some instances - to play down recent fractures.

Sen. Thomas L. Bromwell of Baltimore County, author of a quickly aborted attempt to knock off Senate President Thomas V. Mike Miller, delivered a brief speech endorsing Miller's record-breaking 15th year presiding over the Senate. Bromwell even issued an invitation for Miller to be his guest at the Super Bowl if the Baltimore Ravens advance that far.

Miller, who said later that Senate business would keep him from the game, told colleagues during the ceremonial opening meeting, "Senator Bromwell was, is, continues to be my friend."

However, the cordiality was breached, at least symbolically, by a rare opening-day protest vote against Miller.

Seven Republican senators, smarting from the unconventional tactics Miller used to bring the governor's gun safety bill to the floor last year, refused to vote for his re-election - a vote that by tradition is unanimous.

Sens. Alex X. Mooney of Frederick County, Timothy R. Ferguson of Carroll and Andrew P. Harris of Baltimore County voted against Miller. Sens. Larry E. Haines of Carroll County, Christopher J. McCabe of Howard, and Nancy Jacobs and J. Robert Hooper of Harford abstained.

Six members of the Republican caucus voted for Miller. Sen. Norman R. Stone Jr., the longest-serving member of the Senate, said he could not recall another instance of a vote against the majority party's choice of presiding officer in his 35 years in the chamber.

"You notice three red votes up there," Miller said, nonchalantly referring to "no" votes on the chamber's electronic tote board. "I don't mind those three red votes at all. I understand them."

Miller suggested the votes were the product of "partisanship" of the sort that plagues Congress. "It's very difficult for unifiers such as us to fight against that kind of partisanship," he said.

His touchy-feely sentiment was the order of the day. Throughout the refurbished State House, there were hugs and back slaps befitting a college homecoming weekend.

In the House chamber, Del. Wendell F. Phillips, a Baltimore Democrat, broke out animal crackers in an effort to distract Clarke, his 14-month-old daughter, who was enthralled by the microphone at each desk. "She manages to stay quiet until the governor speaks, and then she ekes something out, just like last year," Phillips said.

Joining the legislators on opening day were lobbyists, former lawmakers, local officials and congressmen.

"I feel like I have my sea legs," said Baltimore Mayor Martin O'Malley, who is seeking additional funding for drug treatment, education and redevelopment in the second session since his election. "I feel we've done a lot better on building alliances."

Across State Circle, some lawmakers had wandered to the Governor Calvert House for a reception thrown by the state's alcohol industry, where a banner proclaimed: "Billions in Sales!"

This year, alcohol interests are worried about efforts to toughen Maryland's drunken-driving laws. Under a new federal law, states that fail to set a blood-alcohol level of 0.08 percent as the threshold for charging a driver with driving while intoxicated will lose some highway aid starting in 2003.

In Maryland, the minimum blood-alcohol level for a driving while intoxicated charge is 0.10 percent. William Pitcher, a lobbyist for Miller Brewing Co., pointed out that for a less severe driving under the influence charge, the Maryland threshold is 0.07 percent.

"I bet you 90 percent of the people in this room are already between 0.07 and 0.08," he said.

The drunken-driving bill is one of many measures expected to be contentious during the session. House Speaker Casper R. Taylor Jr. hinted at another one during a speech after being unanimously re-elected by his fellow delegates.

Taylor applauded the General Assembly's efforts to make sure all Marylanders benefit from the economic growth that has raised the state's per capita income to the highest in the nation. In particular, he pointed to the Children's Health Insurance Program.

He is pushing an expansion of the program to cover 60,000 low-income adults. But Glendening said the state might not be able to afford health care or prescription drug initiatives, saying it was a national problem. "We'll do what we can here, but with the huge financial cost, it may not be workable within our budget," he said.

Earlier, Glendening injected some levity into opening day, but it came with a message.

He greeted the House and then the Senate clutching what looked like a rolled-up architectural drawing. Wielding the poster-sized document like a bat, he declared it the new map of legislators' election districts and offered to hand it over, first to the House Speaker, then to the Senate President.

"On second thought, why don't I just hold onto this until after our legislative plan passes," he said, as members booed in jest.

The redrawing of districts to conform with the 2000 Census is critical to lawmakers' political futures. The governor will play a dominant role in the process.

Sun staff writers Michael Dresser, Sarah Koenig, Howard Libit and M. Dion Thompson contributed to this article.

Originally published Jan 11 2001

Baby dies from Ebola as outbreak nears end

By Gregg Zoroya

USA Today

Thursday, January 11, 2001

The death last week of a 5-month-old African girl infected with the Ebola virus has renewed fears that an outbreak of the deadly disease in Uganda, believed to have nearly burned itself out, might flare up again.

The child's mother died from Ebola on Dec. 22. Health monitors say they had hoped that the adult would be the final victim. More than 170 people have died since the latest outbreak began in late September.

Ebola, named for the river where it was first identified in 1976 in Congo, formerly called Zaire, is highly contagious and causes massive internal damage that can lead to bleeding from several areas of the body. This makes it particularly hazardous for health care workers.

The latest victim, who had been nursing before her mother's death Dec. 22, was then sent home to be cared for by a grandmother and two aunts, said Tom Ksiazek, leader of a team from the Atlanta office of the Centers for Disease Control and Prevention (CDC).

The team was sent to assist Ugandans and monitor the disease.

Initial blood tests had suggested that the infant was virus free. But the child died last Thursday, and tests showed her to be infected with Ebola. Now, medical workers are watching the grandmother and aunts for symptoms. Ebola has a mortality rate of up to 60%, according to some experts.

"It really is a heart-wrenching story here," said James Le Duc, who coordinates CDC emergency response teams.

The infant had been hospitalized in Gulu, Uganda, with meningitis. It was during this period that medical workers now speculate that her mother might have been exposed to the virus . Mother and child were discharged Dec. 20. The mother died about 48 hours later.

Officials, who had been monitoring a dwindling group of people who might have been exposed to the disease, had thought they were within a few weeks of declaring the outbreak over. Then the infant died last week. "I think everyone was sitting on tenterhooks waiting for what might or might not happen," Ksiazek said Tuesday in a telephone interview from Uganda.

Simple tasks such as changing the infant's diapers could have placed someone at high risk of contracting the disease, Le Duc said.

The contagion has been devastating for health care workers in the region. It has claimed the lives of more than a dozen nurses, doctors and other hospital workers . All of Uganda mourned the death Dec. 5 of Matthew Lukwiya, the highly respected medical superintendent at St. Mary's Hospital at Lacor. He died six days after the first symptoms appeared.

It might never be known how Lukwiya was infected. But Daniel Bausch, a CDC doctor who supervised one Ebola ward in Gulu and had conferred regularly with Lukwiya, said there was an incident when Lukwiya came to the aid of an Ebola victim. He said that as Lukwiya lay dying, the physician told Bausch about an infected nurse who became disoriented and fell out of a hospital bed.

"He did not say that when he did that (helped her) there was blood that splashed into his eyes or that there was some other obvious exposure," Bausch said. "but he did recognize that was one event where there was a lot of blood around."

Md. Lawmakers Return To Ceremonial Business

By Matthew Mosk

Washington Post Staff Writer

Thursday, January 11, 2001; Page B01

With all the spirit of a high school reunion, Maryland's lawmakers passed through a jovial gantlet of lobbyists and politicians who packed into the historic Annapolis State House yesterday to help greet the arrival of the 2001 General Assembly session.

An uncertain economy and a markedly smaller surplus have left Maryland legislators facing tough choices about spending for the first time in years. But by the time the House speaker and Senate president banged the opening gavels, costly ideas were already blooming.

Gov. Parris N. Glendening (D) has presented the state's 188 lawmakers with an outline of new spending proposals, including increased funding for higher education, expanded health care coverage and $145 million over the next five years to buy land threatened by development.

And House Speaker Casper R. Taylor Jr. (D-Allegany) told House members that years of fiscal discipline will allow them to continue pushing a progressive agenda that will include expanded health care coverage for the poor and more money for school construction.

"We have accomplished a lot . . . but we can and we must do more," Taylor said, accepting his party's vote to make him House speaker for the eighth time. "In the year 2001, we still have some counties that have a way to go to catch up."

As he spoke, local officials jammed the wings of the House chamber, preparing to scrap for chunks of the state budget.

"We're here to make sure we get our fair share," said Montgomery County Executive Douglas M. Duncan (D).

Prince George's County lawmakers, coming off a banner session last year, were optimistic about their chances to snare big pots of funding this time around.

As they did last year, county legislators spent a good deal of opening day schmoozing and handing out little white and green laminated cards listing Prince George's priorities for the session, including their intention to secure more than $50 million from the state to complete the construction of 26 schools over the next decade.

"There's less money in the pot this year, which means we're going to have to work harder," Prince George's County Executive Wayne K. Curry (D) said. "But that's okay because we're used to fighting to get what we want."

Members of the assembly's vastly outnumbered Republican Party trod familiar ground as they called on Democrats to show some restraint when it comes to spending.

"We've had some very serious warnings about the economy," said Del. Robert L. Flanagan (R-Howard). "This [degree of spending] is not a prudent approach."

In addition to ironing out budget issues, lawmakers will revisit several hotly contested proposals for social policy this year, including measures aimed at ending racial profiling by police, outlawing discrimination based on sexual orientation and cracking down on those who drive drunk.

But yesterday was not a day for policy talk. It was a time for ceremony. Vaunted assembly alumni such as U.S. Sen. Paul S. Sarbanes (D), once a state delegate, and U.S. Rep. Steny H. Hoyer (D), a former state Senate president, delivered warm wishes and called for a session free of the partisanship and rancor that are common in Washington.

The bonhomie even flowed in the Senate, where Thomas V. Mike Miller Jr. (D-Prince George's) was reelected president despite a brief coup attempt last month by Senate Finance Chairman Thomas L. Bromwell (D-Baltimore County). Bromwell tried to engineer a coalition of disgruntled Democrats and Republicans to challenge Miller, but the effort fizzled.

Yesterday, Miller insisted there were no hard feelings: "Tom Bromwell was, is and continues to be my friend," he said.

Tension surfaced briefly when three Republican senators voted against Miller for president. They were Timothy R. Ferguson (Carroll), Andrew P. Harris (Baltimore County) and Alexander X. Mooney (Frederick). It was a rare rebuke when the red lights signaling their nay votes appeared; tradition holds that the vote for president is unanimous. But all three had faced Miller last year in an emotional legislative fight over gun control.

"I don't mind those three red lights at all. I understand them," said Miller, who cited the "poison" of Washington-style partisanship infecting the State House.

In brief visits to both chambers, Glendening carried a rolled-up map of the state's political boundaries, a playful reference to redistricting. The redrawing of political lines, a process that occurs at the start of each decade and is largely controlled by the governor, will almost certainly factor into any equation lawmakers use to cast their votes this year.

"I'll give it to you," Glendening chuckled as he held the map, "right after our program passes."

Staff writers Daniel LeDuc and Tracey A. Reeves contributed to this report.

The High Cost of Selling Blood

By John Pomfret

Washington Post Foreign Service

Thursday, January 11, 2001; Page A01

CHENGLAO, China -- In the flickering light of a skinny candle, her face looks like a death mask: pale, drawn, immutable.

Her eyes are hollow. Her deep cough resonates through mucus-filled lungs. She cannot really walk anymore and spends her time lying on a bed, wrapped in a cotton comforter black with dirt. The collapse of her immune system means even her bedsores are infected. Largely because of her AIDS, her family is so poor that her husband cannot afford $10 to test himself for the disease.

Things were not always this way. Time was when Liu Yinhua and her husband, Wang Deshan, thought selling their blood would pull them out of poverty. It built their house, and at one point the profits paid for medical care that saved their son's life. But Liu, like thousands of other poor farmers here in China's central plains, contracted AIDS by selling blood to dealers who reused

needles, mixed blood products and, after separating out the plasma, reinjected infected blood into her veins.

Partly because of people like Liu, Chinese experts worry that an AIDS epidemic is erupting here, 15 years after the country's first recorded death from the disease. Drug users account for most of the cases, according to official statistics. Sexual transmission of the AIDS virus -- via prostitutes along truck routes and in major cities -- is responsible for a small percentage. But unlike in other areas with high infection rates, such as Africa, many Chinese with AIDS -- up to a fifth of the total -- contracted the disease by selling their blood.

Knowledge and solid numbers about AIDS here are sketchy, in part because the government has spent years ignoring its looming AIDS crisis. In 1996, for example, the government spent $2.75 million on AIDS prevention, one-third of India's spending and one-thirtieth of Thailand's. But the leadership woke up to the crisis late last year after several Chinese scientists warned that the potential economic losses from an AIDS epidemic would erase the gains made by economic reforms.

Still, a months-long attempt to understand China's AIDS crisis indicates that government decisions, cultural traditions and political customs have in some cases worsened the crisis and continue to retard efforts to deal with it.

Statistics in China on AIDS and HIV, the virus that causes AIDS, are considered unreliable even by Chinese officials. AIDS statistics, just like economic information, have been used by ambitious, corrupt or scared officials to cover up failure. Many regions refuse to report true AIDS figures; many of those same regions have blocked Chinese researchers from testing and carrying out AIDS prevention campaigns.

The Health Ministry released its official statistics in late September: 20,711 HIV carriers, up 37 percent from a year earlier. It said 741 had AIDS and 397 AIDS patients had died since 1985, when China's first AIDS death occurred.

But the same day, Deputy Health Minister Yin Dakui called China's AIDS situation grim and predicted 600,000 people would be infected with HIV by the end of the year if prevention and treatment were successful and 1 million if they were not. He Xiong, an AIDS prevention official, believes China already has at least 1 million HIV-infected people. Chinese researchers say

they expect that number to balloon to 10 million in a few years.

A Journey of Sadness

Zhao Pinfu is well-known in the villages around Chenglao, where he operates a small health station. Wherever he goes, local farmers come out to greet him, calling him by his given name. Zhao has been instructed by local officials not to help anyone who comes to the area to study AIDS problems.

"They say it's bad for investment. They say it's bad for China's name, but this problem is killing people," he said. "Someone is responsible for this problem. Someone really should pay."

A trip with Zhao through a section of Shangcai County in southern Henan province, a region of small wheat and onion farms 600 miles south of Beijing, is a journey of sadness.

"In that one 15 people died, there seven, there eight." Zhao is pointing left, right and straight ahead to hamlets split by small streams, covered in fallen leaves. "Just a few months ago a woman came to me. She was eight months pregnant. She was experiencing nonstop diarrhea -- that's a sign for us that it's AIDS. We tested her. She was positive. She got rid of the child.

She died a little later."

While AIDS is generally contracted through sex or drugs in the rest of the world, it came into Chenglao and the rest of Shangcai County by blood.

For decades people from Shangcai and other counties in Henan, Hebei, Anhui, Shanxi and Hubei provinces relied on selling blood to pad out a lean year or to live a little better in a fat one. China's government used to force its citizens to give blood, but after economic reforms in 1978 donations fell off and a market in blood emerged. Farmers in Chenglao, for example, said they

have been selling blood since the early 1980s. Before a government crackdown in 1996, they said, they routinely made $250 a year for about 80 sales of one to two pints each, equal to their income from farming.

The blood market got a massive boost in 1993, according to a senior Chinese scientist, when then-Health Minister Chen Mingzhan approved a plan to export blood products to earn foreign exchange. Demand shot up. Foreign firms began buying Chinese blood, as did Chinese blood companies, many linked to the Chinese army. Middlemen appeared, called blood heads, who bought blood from farmers and sold it to hospitals, blood banks and blood product companies.

"This decision created a massive new demand for blood," the scientist said, speaking on condition of anonymity. "Blood heads rushed into these villages and began using new techniques to get more blood faster. Blood companies were right behind them pressing them for more blood."

One technique involved removing the valuable plasma from the blood and then returning the blood to the sellers' veins so they could give blood again sooner. To save time and money, blood heads would often hook several sellers of the same blood type up to one machine, taking their plasma but mixing their blood. When AIDS entered this equation, the results were disastrous.

No testing was done for HIV in the beginning. Shangcai County is now believed to have as many as 10,000 HIV carriers, a local health official said.

The senior scientist said his figures indicate hundreds of thousands of blood donors all over China were infected in this way. He and other researchers say the blood market was a major catalyst for the AIDS explosion in China.

In 1993, China had 10,000 HIV-positive people, he pointed out. They were overwhelmingly drug addicts and sex workers, considered easy to control. By the end of 1994, a year after the export craze began, the problem had exploded. And by 1998, AIDS, which had once been confined to Yunnan, Beijing, Shanghai and Guangdong, had spread to all 31 provinces and major cities in China.

Officials first noticed a problem when batches of blood from Guan County, near Beijing, turned up carrying the AIDS virus at the end of 1994. The National People's Congress passed laws in 1995 and 1998 seeking to halt the selling of blood and reestablish the donor system.

But many Chinese do not like giving blood, considering blood sacred. So blood banks and hospitals -- and China's vast pharmaceutical industry -- are still short. Blood selling continues. And testing, while in theory mandatory, is still not widespread. Chinese newspapers and magazines began reporting on the connection between AIDS and blood sales in August with publication of a shocking article in the official China News Weekly. Southern Weekend, one of China's most popular weeklies, devoted a full edition in November to AIDS and the tribulations of infected blood sellers in Henan.

The Health Ministry does not publicly acknowledge the importance of blood selling to the AIDS problem. But in its latest statistics, researchers say, lies a secret. Those statistics say 72.1 percent of Chinese with HIV were infected by sharing needles for drug use and 6.8 percent were infected through sex. The cause of remaining 21.1 percent is labeled "unknown." That, according to Southern Weekend, is a euphemism for blood.

"Of course they won't acknowledge it," the senior scientist said, "but they made serious mistakes. One day, just like in Japan, France, Canada and other countries where HIV entered the blood banks, these people will pay."

Sex Industry Growing

Throughout the 1,600-mile trip from Guangzhou to Beijing along Highway 107, China's main north-south artery, the roadside is dotted with dance halls and brothels servicing truckers. The Chengang Hotel is one of them, run by a former officer in the People's Armed Police.

"This place is amazing!" confided Liu Tieming, a trucker from Tianjin. "Really amazing. The girls do anything you want!"

Although the Health Ministry says only 6.8 percent of those carrying HIV in China got it through sex, He Xiong, the government AIDS prevention official, says sexual transmission is rising, especially on China's richer east coast. One reason is that Chinese are increasingly embracing a more relaxed lifestyle. Premarital sex is the norm now for China's urban middle class. And China's sex industry is growing fast.

A U.N. study found 57 percent of prostitutes in China say their partners never use condoms. The figure is 70 percent in Beijing. Another study showed men were willing to pay more for sex without condoms. "Chinese men don't like them," said a woman of 19 who called herself Flower Bud and works at the Chengang. "What can we do about it?"

According to a recent Chinese poll taken in 60 cities, only 3.8 percent of the population understands how HIV enters the body; 80 percent, if they know of AIDS, think one contracts it through the air. A survey of doctors in eight cities indicated medical professionals know little more about AIDS than other citizens.

Now, however, Chinese actors and other stars are speaking out about AIDS. Backed by the United Nations and the World Bank, China has launched education projects with sex workers in certain areas and is distributing condoms. Another step is distributing single-use needles or orally administered heroin substitutes to drug addicts. But police have slowed that measure, arguing that it encourages drug use and does not necessarily prevent AIDS.

A Teenager's Ordeal

Song Pengfei was barely a teenager when he received a transfusion of tainted blood from a blood head in his home town in Shanxi province after a doctor mistakenly cut into an artery during a routine medical procedure. Two years ago, the waif-like teenager became one of the first Chinese to publicly acknowledge he is infected with HIV, a bold move in a society still struggling with how to deal with the issue.

At first China's media embraced the boy and there was hope among Western AIDS specialists that Song could play a role similar to that of Ryan White, the young hemophiliac AIDS patient in the United States who died in 1990. But in April 1999 the hospital in Shanxi that had been paying for his medical treatment cut Song off, saying it did not have the funds. After reports appeared about Song in the Western media, an American charity, the Phelex Foundation, stepped in; it is paying for the "cocktail" of drugs designed to suppress AIDS from a Saving Song Pengfei Fund.

In October 1999, when Song traveled to Malaysia for an international conference on AIDS to highlight China's bloo d supplyproblems, the Health Ministry launched an investigation to determine how he was invited and how he was allowed to leave China. A whispering campaign began, charging that Song was being used to denigrate China. China's state-run media do not

write about Song anymore.

"Before, the government said AIDS was only a problem for prostitutes and drug users. The rest of China wasn't supposed to have AIDS," said Song, who lives in a drafty one-bedroom apartment with his mother and father in Beijing. "But I was an example of how AIDS is inside the rest of China."

"This child had the courage to stand up and say, 'I have AIDS,' " said his father, Song Xishan. "You should encourage him. You should use him as a model of how not to get AIDS, a reminder of the dangers. Instead, they politicized the issue, not us."

Song's case illustrates how China's political sensitivities and government fears about liability have held back efforts to control the spread of AIDS. Chinese researchers, for example, have been blocked for years from testing for HIV in Henan and other provinces.

Tipped off by a student about the problem in southern Henan, a doctor from Wuhan, Gui Xien, went to villages in July 1997.He tested 11 people; 10 tests came back positive, Chinese media say. He then offered a county health department free AIDS tests. The health department refused. Gui sneaked back into villages two months later and did follow-up tests. Of 140, about 80 came back positive, the media reports said.

Gui addressed a report to the Henan provincial government, which ignored it. In October 1999 he went to Beijing with the results of subsequent tests; only after one of China's vice premiers, Li Lanqing, wrote comments on the side of his paper did Henan acknowledge that it had a problem.

Back in Chenglao, Wang Siying and his wife, Liu Sanyi, who have sold blood for 30 years between them, have pulled their 14-year-old daughter out of school because they cannot afford tuition. Their 9-year-old son will probably drop his studies, too. In September, Wang, a 38-year-old former soldier, noticed a ring of blisters around his waist. A low-grade fever set in.

Wang got himself tested. He unfolded a piece of rice paper: HIV positive.

"Blood built my house. Blood built all of the houses of this village," Wang said. "Now blood is killing us."

Deaths Tied to 'Date Rape' Drug Kin

Washington Post

Thursday, January 11, 2001; Page A08

At least two people have died from a chemical cousin of GHB and six others have overdosed in the decade since the government banned the sale of the "date rape drug," a study found.

The overdoses took place in Minnesota, Texas and Florida and were blamed on 1,4-butanediol, which turns to GHB in the body.

Butanediol is used as an industrial solvent and is also included in supplements sold under names such as Thunder Nectar, InnerG and Zen.

More such overdoses have almost certainly occurred but have gone unreported, in part because many coroners and emergency rooms do not test for GHB, said medical anthropologist Deborah L. Zvosec, a Ph.D. who led the study published in today's New England Journal of Medicine.

Butanediol can cause dizziness, seizures and coma, and can slow breathing to dangerous levels. It can intensify alcohol's effects and is also said to be more dangerous when taken with other depressant drugs.

The butanediol overdoses all occurred after the Food and Drug Administration banned over-the-counter sales of GHB in 1991. Last year, Congress also made possession of GHB illegal.

GHB, or gamma hydroxybutyrate, is sometimes used at all-night rave parties. It is known as a date rape drug for its ability to incapacitate people and leave them vulnerable to sexual assault.

Ward Dean, author of a book titled "GHB -- The Natural Mood Enhancer" and defense witness in a number of GHB cases, said the journal study is another attack by people who are biased against the drug.

1st Angioplasty Vein Still Clear

Twenty-three years after Andreas Gruentzig of Switzerland nervously made medical history by threading a balloon-tipped tube into an artery supplying Adolph Bachman's heart, the blood vessel is still unclogged.

An exam done last April on Bachman showed that blood was flowing freely, according to a report in today's New England Journal of Medicine on the world's first balloon angioplasty -- a procedure that is now performed about 700,000 times a year in the United States alone.

Bachman was 38 when he was told that Gruentzig had an alternative to bypass surgery. It was a treatment that had worked in leg arteries but had never been tried on the heart: inserting a tiny catheter into the artery, then blowing up a balloon at the end to squash the blood clot blocking it. Gruentzig had designed the prototypes in his kitchen.

Gruentzig did Bachman's angioplasty on Sept. 16, 1977, at University Hospital in Zurich, Switzerland, despite great skepticism from others and resistance from his superiors, said Valentin Fuster, whom Gruentzig consulted.

The angioplasty eliminated all of Bachman's symptoms, Meier wrote in the journal report. The patient quit smoking and soon stopped taking all his cardiac medications. A few years ago, he began taking aspirin and cholesterol-lowering drugs.

Gruentzig died in 1985.

-- Compiled from reports by the Associated Press

Femara Approved As 1st-Line Drug For Breast Cancer

Associated Press

Washington Post

Thursday, January 11, 2001; Page A15

The government approved the use of a drug called Femara to fight advanced breast cancer, suggesting it as an alternative to today's top treatment.

The Food and Drug Administration's decision yesterday may bolster a growing shift in how specialists treat late-stage breast cancer as a new class of drugs challenges the standard therapy, tamoxifen.

Femara is not a wonder drug. There is no proof yet that it helps patients live any longer than tamoxifen does.

But an international study of 907 postmenopausal women with advanced breast cancer found that it provided patients a median of 3.6 more months before tumors worsened than did tamoxifen. Overall, the risk of the disease worsening was 30 percent less among Femara patients than among tamoxifen patients.

Experts call that a meaningful length of time for a late-stage cancer, particularly because it lets women postpone the consideration of more toxic chemotherapy.

So late yesterday, the FDA approved Femara, known chemically as letrozole, as a first-line therapy for metastatic breast cancer, the kind that has spread through the body.

Novartis Pharmaceuticals Corp. already sells Femara as a backup for when tamoxifen fails. The FDA's upgrade of the drug puts it in a position to challenge tamoxifen as the most-used therapy for breast cancer patients.