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JOHNS HOPKINS MAGAZINE. 1989 Feb; 41(1):10-1.The reuse of unsterilized syringes is spreading AIDS, hepatitis B and the African Ebola-Marburg virus. In the US 25% of the AIDS cases are related to intravenous drug abuse. In developing countries syringe reuse is related to poor health care delivery systems. In these countries syringes are used over 5 times before sterilization; in some countries the syringes are distributed by people who sell injections of vitamins and antibiotics. In 1986 Halsey challenged the medical community to design a syringe that would not transmit these diseases, and shortly thereafter a separate challenge was issued by the World Health Organization. The requirements of this syringe are its self destruction after use, little requiring retraining of medical personal, and no more than 1 cent to the cost, and be simple to make. These challenges brought 70 various syringe entries and all but 3 were eliminated. The Hopkins syringe is similar to a regular syringe except it has a polymer insert that seals up after one use. When water flows around the polymer insert it swells and closes off the passageway preventing any liquid from flowing in or out of the syringe. Another syringe seals up in 2.5 minutes which allows the health worker time to draw and inject a patient before the syringe destructs. By using hydrogels that are already approved for use in contact lenses and food substances, the safety has been tested. Companies looking at production costs estimate that the polymer insert will add only 1/4 of a cent to the cost of a syringe.
Washington, D.C., National Academy Press, 1988. x, 239 p.The Committee for the Oversight of AIDS Activities presents an update to and review of the progress made since the publication 1 1/2 years ago of Confronting Aids. Chapter 1 discusses the special nature of AIDS (Acquired Immunodeficiency Syndrome) as an incurable fatal infection, striking mainly young adults (particularly homosexuals and intravenous drug users), and clustering in geographic areas, e.g., New York and San Francisco. Chapter 2 states conclusively that HIV (Human Immunodeficiency Virus) causes AIDS and that HIV infection leads inevitably to AIDS, that sexual contact and contaminated needles are the main vehicles of transmission, and that the future composition of AIDS patients (62,000 in the US) will be among poor, urban minorities. Chapter 3 discusses the utility of mathematical models in predicting the future course of the epidemic. Chapter 4 discusses the negative impact of discrimination, the importance of education (especially of intravenous drug users), and the need for improved diagnostic tests. It maintains that screening should generally be confidential and voluntary, and mandatory only in the case of blood, tissue, and organ donors. It also suggests that sterile needles be made available to drug addicts. Chapter 5 stresses the special care needs of drug users, children, and the neurologically impaired; discusses the needs and responsibilities of health care providers; and suggests ways of distributing the financial burden of AIDS among private and government facilities. Chapter 6 discusses the nomenclature and reproductive strategy of the virus and the needs for basic research, facilities and funding to develop new drugs and possibly vaccines. Chapter 7 discusses the global nature of the epidemic, the responsibilities of the World Health Organization (WHO) Global Program on AIDS, the need for the US to pay for its share of the WHO program, and the special responsibility that the US should assume in view of its resources in scientific personnel and facilities. Chapter 8 recommends the establishment of a national commission on AIDS with advisory responsibility for all aspects of AIDS. There are 4 appendices: Appendix A summarizes the 1986 publication Confronting Aids; Appendix B reprints the Centers for Disease Control (CDC) classification scheme for HIV infections; Appendix C is a list of the 60 correspondents who prepared papers for the AIDS Activities Oversight Committee; and Appendix D gives biographical sketches of the Committee members.