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From: ((Steven B. Harris))
Subject: Re:leelab:HIV fecal route
Date: 22 May 1995

In <> (John
Cherwonogrodzky) writes:

>Dear Colleagues:
>    I'm a bacteriologist, not a virologist, but it seems to me that the
>fecal route for the transmission of HIV (I think initiated by "leelab")
>is an excellent question. I don't know enough about this field. Are
>retroviruses spread by this way? I recall reading where hepatitis virus
>is a good model for HIV and the former is spread by fecal contamination -
>are both statements true? Thanks...John

Only hepatitis A is really spread by fecal contamination.  The
epidemiologic model for HIV is hepatitis B.  During WWII consciencious
objectors actually swallowed capsules of stool from Hep B patients to
prove that it is NOT transmitted this way.

I have been wondering privately, however (warning: speculation here) if
the KS virus HHV-8 is not a fecally spread virus, much like Hep A.  That
would explain a lot about the epidemiology of KS in AIDS and in Africa.

                                                 Steve Harris, M.D.

From: B. Harris)
Subject: Re: Hepatitis A
Date: 21 Oct 1998 07:26:38 GMT

<AB067A2997CE68C4.5B2C90F8917E4107.E5015D96EEAF58F4@library-proxy.airne> (Jonathan R. Fox) writes:

>Vaccination is not routinely recommended in the U.S.A. presumably
>because it is not an endemic area the way some other locations are.
>In the U.S., we tend to have local communities which are endemic, or
>we have occasional outbreaks.  Given this fact and the fact that the
>vaccine has only recently come into use, and its long-term usefulness
>is unclear, we do not vaccinate everyone in general.

   Nah, we don't because the HMOs don't want to pay for it.  But
anybody can get hepatitis A, just by shaking hands with the wrong
person and sticking a finger in your mouth later.  Or eating at the
wrong restaraunt.  My advice is shell out the money and get the two
painless shots, which usually cause no reaction.  If you get sick, of
course, odds are good you'll lose far more in productivity than the
vaccine costs. But when you multiply this by your chances of getting
sick, does the cost come out in favor of the vaccine?  Probably not.
But that doesn't count intangibles, such as how much it's worth in
money for you not to be sick, not counting the income you lose and
expenses of same.  You might even die-- what's it worth to you to
decrease those odds.  This is one case (as with hep B) where "cost
effective" is not appropriate if you're willing to spend money to
decrease your odds of getting a nasty disease, just because you don't
want to suffer.

                                       Steve Harris, M.D.

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