I Dramatic 'Cloning' Story Cloned More FearThan Fact- P.4-5

DavidZimmerman 's newsletteron science, media,policy and health Vol. III, No. 2 January 1, 1994, New York,NY $5 AIDS Researchers Shift Course Resistance Studied Rethinking Vaccines ------washington, DC Washington,DC Some people - but not very many - appear to be naturally Results in human trialsof experimentalAIDS vaccinesthus far protected against HIV (human immunodeficiency virus),which have been disappointing. Few if any of the volunteers who causes AIDS. While often exposed to the virus, they do not have been injected appear to have developed a protective become infected. immunity against HIV that comes dire.ctly from other people Some other individuals - again, not many - who are (wild virus). infected (HIV positive) remain disease-free and well for a re­ This dilemma provoked much disc�ion at last month's markably long time. This suggests that they, too, may harbor Instituteof Medicine (IOM) meeting here (seeadjacent story). some innate protective factor(s). The attraction of a vaccine,besides being the only method Theseputative protective factors, whichresearch leaders are that may one day stop the AIDS epidemic, is that, despite tentatively calling ''correlates of protective immunity to HIV setbacks, there are tantalizing clues that this approach might infection," were brought to center stage at a Dec. 10 brain­ work. stonning meeting convened here by the Institute of Medicine One clue is that, as in other infectious diseases, once a (IOM), an arm of the National Academy of Sciences. person has been infected, he or she is protected, as it were, Three factors,participants said, spurred IOM: from a second HIV infection from another person or source. • As time p�s, more and more long-tenn resistors and The evidence for this, virologist Lawrence Corey, M.D., of survivors of HIV infection have become evident and are avail­ the University of Washington, in Seattle, explained, is that able for study. Internist Jay A. Levy, M.D., a pioneer AIDS HIV positive individuals rarely are found to be carrying researcherat the University of California,in SanFrancisco, said more than one or variant, of the virus. (A number of he and his colleagues now have 70 long-tenn survivors among variants,with differentgeographical distributions, have been the thousandsof homosexual men theytreat. identified throughstrain, genetic and molecular comparison.) This • Interesting data is becoming available on some dramatic suggests, Corey said, that people can be successfully pro­ instances of resistance. Particularly,a couple dozen prostitutes tected if vaccines are developed that cause a strong enough continued on page 7 immunologic response, directed toward a common trait of the virus. Alternatively,a vaccine ''cocktail'' that protected God's Blessing? against several or more strains may be needed. magazine's �airobi .corre$1)0ndent, Andrew Purvis, Needs Are Debated found and interviewed Agnes Munyiva, who hasescaped Thediscussion turned often to the riddleof which of thetwo AIDS1ime during her 13 years as a prostitute (Dec. 6). ''To arms of the immune system, the humoral arm thatproduces feed her family of five," Purvis reports, Munyiva anti-HIV antibodies, or the onethat mobilizes killer T 0 entertains as many as 10 clients a day on her children's cells againstviral invaders,must be activated to protectagainst bed,charging the going rate of2S centsa trick. . . . Her mv. Or, must it beboth? cellular kids - forced to play outside in the· mud while their Most of the current experimental vaccines stimulate bu­ mama'has a guest'-often go hungryon a skimpydiet of moral immunity. Most, too, are made of synthetic (artificial) cornmash.'' fragments of HIV. They have the advantage that they can Nevertheless,Munyiva considersherself lucky. never causean HIV infection; theyare inert. But theyhave the. "Perhaps Godknows that ifhe takes me away, my disadvantage that they challenge the vaccine recipient's im- childrenwould suffer," said. she continued on page6

© 1994, DavidZimmerman, Inc. converted into the neurotransmitter serotonin in the body. Prisoners with a variant of thegene that produced low levels of p serotonin were more violent than prisoners who had an Follow-U ... alternativevariant that yielded higher- and morecalming - levels of serotonin (seestory, p. 7). The Weaselword: We and many others have reported the This researchwas attackedby black activists,who objected cigaretteindustry's strategic ploy, over many years,of keeping to studies that might link violent behaviorto genetic traits. open a window of doubt thatsmoking is dangerous in order to The study originally was sent to Nature, which rejected it. reassure presentsmokers and lure new ones. But it will be published this month by the American Medical A pe_rfect exampleof this arose in the wake of Ed Rollins' Association in its Archives of General Psychiatry. We hear confabulatoryadmission that the Republicans had bribedblack that the study, which has been expanded, contains some sur­ church leaders to hold down the Democratic vote in the New prises-and we'll reporton them next month. Jersey gubernatorial election. The brouhaha that followed # # # providedan opening for New York Timescolumnist Bob Herbert to pointout thattobacco companies have for yearsbeen paying We've been trying to think about the biological, social and off black politicians and reaping positive publicity through criminal definitions of aggression, violence, etc. This is bow sponsorship of events like the Virginia Slims women's tennis we see it: Aggressionis a psychological and physiological trait tournament (N r Times,Nov. 21). that may beexpressed inj uriously asviolence towardoneselfor Herbertprovoked l anaangry riposte from Virginia Slims tour- others. Illegal violence is a crime. namentfouiiaer; eniiis ce B1Ihe Jeari"1Cffig(N.f7im-.� ;-0e_.c .------· ------·------�---- 2). She said of the sponsor: Self-destructSyringes: Massachusetts,as we have reported "The Philip Morris executives I know do not hide behind (Feb. '92), passeda law that all syringes sold there, startingthis ignoranceor anything else. They areenlightened people who month, must self-destruct. This means the instruments could understandand acknowledge the possible hazards of smoking." be usedonly once, andthen would break, or lockpennanently

The weasel word, of course, is possible. King's use of it, with ethe needle retracted. moreover,is sufficientlyambiguous for it not to be clearwhether Halth workers thus would not suffer needle-stick injuries shemeans hazardous to every smoker - which it is not -or that can transmit AIDS or other diseases. The self-destruct objectively hazardousto many of them. Which it certainly is. (SD) syringes alsowould prevent drug abusersfrom sharing the instrumentsand infecting each other. Drugsfor Violence?: We reported last Aprilthat a violence As the deadline for compliance approached late last year, gene had been located by neuroscientist David A. Neilson, Massachusettsofficials and other interested partiesmet -and Ph.D., and his associates at the National Institute of Alcohol discoveredthat no manufactureris ready andable to supply the Abuseand Alcoholism, in Bethesda, Md. Studying imprisoned safer syringes. An industry source saidthat a one yeardelay for violent offendersin Finland, they foundtwo variantsof a gene enforcingthe law may be needed. that controls the rate at which the amino acid tryptophan is Some safer injection equipment already is being put in place. The Massachusetts General Hospital, in Boston, is switching to syringesthat have automatic sheathing devices - HealthResolutions but may not be tamper-proof enough to keep addicts from reusing them. Offeredfor NewYear The hospital estimated its additional cost at close to $1 . . . . million per year. But, it said, in a study presented to the Medical science hasadv anced crement ly the last year m al m m _American Federation of Clinical .Research that needle-stick its under ding of ays to prevent, diagnose, andtreat illness. � � injuries arecostly, as w;II as dangerous -•and the safer ne�­ But the tmportan� things that people can do forthemselves to equipment will earnback someof this expense. stay healthyremam remarkably constant . --•·------Theyare simple to say, but.harder to do. Here are our perennialhealth resolution proposals:

I. Don't smoke. PROBEEditor and Publisher 2. Drive slower; buckle up. David R. Zimmerman Production Comptroller 3. Exercise more. Angela M. Darling Veva H. Zimmerman 4. Eat moderately; consume less fat, more fiber. Circulation: Tom Gilgut 5. Drink alcohol in moderation. PROBE is written and published independently,on a monthly 6. Work and play safely. schedule. Subscription: $53 per year. Editorialoffice: 139 West 13th St., New York City, NY 10011-7856. Phone: 212- 7. See your doctor annually. 647-0200. For subscriptions, Box 1321, Cathedral Station, 8. Practicesafe sex. New Yone, NY I 0025. Contents of thisnewsletter may not be reproducedwithout pennission. ISSN 1062--4155 9. Get flushots and other vaccinations. HEMltEII. NEWSLETTER l'UBLISHEllS ASSOCIATION nn I 0. Relax and enjoy! a Page2 Probe 'Flaws' Killed the time. attention, and disagreement of dozens of scientists, Investigators, and lawyers. [This) all focused essentiallyon the meaningwhich we should,Jve a handful of words and notation contained In one heavily edited Science Cops' paper written by a scientist with limited English sklUs, duringa volatileperiod scientffic cl discovery decade a ago. The continues,board sarcastically, inits decision: BellwetherCase ''One might anticipatethat ftom all thisevidence, after all thesound and fury, there would be atleast a residueof palpable wrongdoing. Thatis not the case [emphasisadded]." Inrecent issues we describedsome reasons why we think the Rather, it ruled, "ORI was simply unable to prove by a quasi-scientific and quasi-legal system that the federal preponderance of the evidence that Dr. Popovic is guilty of government has set up to investigate and punish scientific scientific misconduct - even under standards first promul­ misconductis a mistake: It harmsscience andscientists, and it gated [ ex postfacto] years afterthe paper waspublished.'' bannsthe individuals andsociety they serve. The board asks''how it could happenthat such a massive One area we have not adequately delved into is the very effortproduced no substantialevidence of its premise?'' They sJoppy andmalicious charges that have beenconcocted against answer thatORI's findingscontain ''fundamental flaws.'' accused scientists by the Public Health Service's Office of The boardlisted five "general flaws" in ORI's case: Research Integrity (ORI)and its precursor agencies. • :Eachfinding of scientificmisconduct reading wasbasedon in We of courseare not alonein theseviews. A roguegovern­ a particularway language that was, in context,merely amb�. analysis ment office affronts many individuals and • The opinions offered by ORI's scientific advisors at the interests - particularly when that bureau­ appeals board hearing on the case were based onmisunder­ cracyrepresentsthe fed. Recently, however, standingsabout what was involved in theresearch at issue and a government panel hasjudged ORI's work what Popovic and othershad said. product,and confirmed and extended the complaintsabout it. • ORI's advisors drew unreasonable inferences from non­ Thisharsh judgment camein adecision by anappeals board scientificevidence in thecase. of the Department of Health andHwnan Services (HHS). The • ORI andits experts did not have a clearidea of the proper board is madeup of HHS lawyers. legal andscientific standards to apply to Popovic's conduct. The case in point is that of Mikulas Popovic, M.D., a • ORI assigned an importance to mattersthat was not justi­ virologist in the lab of Robert Gallo, M.D., at the National fiedwhen the paper is examinedas awhole. Institutesof Health (NIH). Popovic, who was bornand raised Thereviewers go on to say,scathingly: in Europe, was the first person to coax the AIDS virus, now "None of the matters [ORI alleges] here has any signifi­ called mv (hwnanimmunodeficiency virus), to growin a cell canceto thevalidity of themajor conclusions of thepaper!' cultme. This is the step which, made possible the blood test The appeals board then di�cts the ORI's case point by thathas all but wiped out theAIDS riskof bloodtransfusions. pointin greatdetail. Theyconclude: Popovic, Gallo and their co-workers reported this work in "ORI did notprove by a preponderanceof the evidence that Science onMay 4, 1984. The HHSappeals board notes that the Dr. Popovic engaged in scientificmisconduct by intentionally reportis "regardedas a'tour de force' of science.... a seminal falsifyingcertain methodsor datareported in the ... paper,or # # # wQl'k,possibly the mo� imt><>��,paperin virologyin the20th even prove that the methods anddata at issue were untrue.'' century.'' It alsois the reportthat researchers at the Pasteur Institutein Parisclaim was a theftof their discoveries;and it is thereport that Chicago Tribunereporter John Crewdson,Con­ Even if it could be shown that there is need for an Office of gressmanJohn Dingell (D-Mich.),and ORI have alleged to be Research Integrity- and doubtwe that there is - thepresent evidence of misconductagainst Popovicand Gallo. ButORI has ORI officials' abysmal and embarrassing work product show aclcnowledgedAppeals Filedthat Popovic'sfaults were "relativelyminor." that this office has failed. Its leaders should resign. Or they shouldORI:be fired In by Its HHS Own chief Donna WritShalala.

Both Popovic and Gallo appealed ORI's findings to the appeals board. In November, the board found for Popovic, The Public Health Service's Office of Research Integrity overruling ORI. The ORI thendropped its caseagainst Gallo, (ORI)published 1w a long-awaitedbrochure that describes which wasbased onmuch thesame purported evidence. itswork: ORI-An Introductionswnmarizes the agency's Theboard's finding in Popovic is noteworthyfor its wither­ complexlegislative and bureaucratic history, describes and ing analysisof ORI'scase. TheHHS lawyers say, withevident how ORIfunctions in ''protecting" research integrity. The case parse a reflecting annoyance: pamphlet also tells how to file a misconduct complaint [l]his hascompelled us to record againsta scientist. ORI officials'names andnwnbers phone yearsof investigations,thousands of pagesof documents arelisted. For a copyof thepamphlet, write ORI/USPHS, and lawyers' briefs, a hearingwhich lasted 12 days, and 5515 SecwityLane , Suite700, Rockville,Md. 20852. Januaryl, 1994 Page3 \ TimesStory on a CloningExperiment The human cloningstory has been vastly distorted. "cloning" exclusive. It turns out, too, that it was ethicist Much of what appears to havehappened has not. Much of Caplan whotipped Kolata off to Hall's experiment(Time, Nov. what hasbeen written _and saidis simply wrong. 8). Thenews magazine notes thathe suppliedher with conjec­ Whatdid happen? tures on methodhow the -which he seesmorally m suspect­ The story was a scoop for science writer Gina Kolata, on mightbe misuseddestroy to mankind's treasuredsense ofhwnan page one of the SundayNew York Times (Oct 24). But, in a individuality, asKolata reports in a fi>llow-upstory (Oct. 26). dramatic demonstration of how a reporter's predilections can In short, with Caplan's help, Kolata fulfilled her own shape the news, Kolata had closely foreshadowed her cloning Cassandra-likeprophecy within one week'stime. report in a piece published the previous Sunday (Oct 17). She wrote it before she learned that reproductive biologist Jerry L. Enterprise Is Rewarded Hall, M.D., at George WashingtonUniversity, in Washington, Kolatais one of theTimes'most enteiprising sciencereport­ D.C., bad separated several two-cell human embryosinto single- ers. She seeks andfinds odd, offbeatand often very important cellorganisns (zygotes), acoording to Kolata's Sl>UJ'Ce story. on1he stories that colleagues miss -which is precisely what a good In the experiment, the separatedcells began to redivide, and reportershould do. She also makes more mistakes thansome ···grewinto mwti:-ctm-emlffyu-s-:.=wtit Hatl·destro-yell•tlfenf:-Tbis -· ·other 1Yme.rootleagueS"thinksheooght to:·• Her,bandlingof the relatively simple experiment thus duplicated the events that cloning story-whichshaped all of the otherexplosive cover­ occur naturally in the conception of identical twins. It showed age that followed- may be one such error injudgement. that doctors may be able to increase the number of embryos She and the bioethicists she phoned speculated wildly that available for implantation into the uterus of a woman who has parents might choose to grow out multiple copies of identical sought medical help, with her mate,for infertility. Thisin tum embryos at different times, so that one child would be older would improve the couple's chancesof having their ownbaby. thanhis or hertwin. Or, parents mightraise clones for replace- ment organs if the first babybecomes injured or ill. Or, they Fears Explored might fteeze, store, and later sellcloned embryosto strangers, In her earlier Sunday piece, Kolata explored the vilification basedon how brightor beautiful thefirst-born clone turned out. of doctors and science -the Frankenstein scenario- that we The scariestscenario, however,which was (Pardon the pun!) have discussed here (PROBE, Sept.). But where we see the cloned throughout the media, is that the method might be scap,goatingof scienceand reason by irrationalistand commer­ developed to make multiple copies of particular living indi­ cial interests, Kolata reached an opposite conclusion: People viduals-Dan Rathers, say, or DanQuayles, or even Hitlers. are fearful and angry because of the hubris and greed they Thisis wholly farfetched. It can't be done!if And it could, discernin doctorsand in the biomedicalbusiness. it would entail an entirely different type of cloning procedure Kolata quotes University of Minnesota bioethicist Arthur than the one Hall performed. Thus, what he did is nota step Caplan, Ph.D., as saying scientists still win high ratings in down a slippery experimentalist slope that could lead to 100 opinion polls. But, he continues, ''it is also clear that bubbling Hitlers,as much of the coverage suggests beneath the surface are primeval fears about profiteering and The essential difference is this: What Hall did was to science and technology run amok, and scientists whose egos separateand regrow two cells that each carried potential, but as knowno bounds.'' yet unexpressedand unknown traits, fromeach of twoparents. c:.The�.aweek ..latet,.l

Page4 Probe Cloned ManyMore Fears ThanFacts \ ably three or fom copies of the original embryo, but certainly cause forconcern to a largegroup of people: Catholics, funda­ not dozensor hundreds. mentalists.'' He added: Halldid notrespond to repeatedrequests forcomment. ''They are absolutists!'' 'Twinning' Preferable If Caplan sharedthis importantexplanation with Kolata, she did not share it explicitly with herreaders. In her follow-up One colleague, reproductive biologist Jacob Mayer, Ph.D., story (Oct. 26), she did, however, quote the Vatican's official of Hoag Fertility Services in NewportBeach, Cal., thinksthat newspaper, which branded Hall's experiment "a perverse Hall'smain errorwas in callinghis procedme''cloning.'' The choice''and ''venturea into a tunnelmadness.'' better word for it, Mayer said recently by phone, might be Other critics included Jeremy Rifkin, who vehemently op­ ''twinning'' - a designation thatcould have forestalled, or at posesmost if not all forms of bioengineering. leastsubdued, the subsequentuproar. ConstraintsAre Present Kolata's stories do not clearly distinguish between cloning unknownembryos andcloning whole humanbeings. This was In news storiesKolata and other science reporters arecon­ a criticalerror on her part. Therest of the media went withthe strained in their ability to point out how scientific advances 100Hitlers or eightidentical cute kids (Time) scenario,particu­ have become footballs in long-standing ideologicalor political larly in the picturesthat illustratedtheir reports. battles. For the most part, reporters must make do by quoting Someanimals, lizards particular, in naturally reproduce them­ the combatants,not reporting their biases. Thisis why prompt selvesasexually in this way. But even if it could bedone with analytic commentary on the op-ed page or elsewhere in the hwnans - which again, it can't - the cloned individuals papermay be critical to public understandingof science. couldnot grow up in identical ways. Life is a river in time and Kolata could nothave knownwhen shewrote the storythat in space, and where one enters determines who one becomes. it would endup in newspaperdom's prime position: above the A second Hitler might have ended up a house painter, or fold on the Times' Sunday front page. But she and Caplan become a streetcarconductor - or the head of a bank. should have sensed, and spoken to thepossibility of hysterical 1be scenarios suggested for Hall's type of cloning seem misunderstanding, rather than cater toit by suggesting bizarre similarly farfetched. Mostparents, we think, seek variety, not ways the methodmight bemisused. similarity in their offspring; identical twins are considered a Kolata never published a corrective. But the Times did mixed blessing at best. Most parents, too, think their kids finally print one, on the editorial page, almosttwo weeks later are unique. So it's hard to imagine them selling copies to on November6 (seebox). others. By then,however, thedamage had been done: ManyAmeri­ Loopiness Decried cans already are convinced that cloning hwnan embryos is witches' work - not a rational prospect for aiding child.less BioethicistCaplan, in a recentphone interviewfrom Minne­ couples. apolis, confinned Time's report that he bad beenthe sourceof some ofKolata'sscary scenarios. But, he said, he was ''more Record Rebalanced the source'' of the notions aboutpossible uses of newly con­ When a Ti� writer goes overboard on a story, the ceivedembryos for thetwinning type of cloningthan he wasa paperdoe s not chastisehim or her publicly in itspages, source for '�a lot of the loopyt�ff'' about raising spare parts ''butrather publishes a conectivearticle,-calleda slcinback, babiesor cloningHitler. to rebalance the record. The balancing piece for the He saysthe commentsabout Hitler were ''flip''- andthen "cloning" story appeared as a Times editorial, "My weretaken seriously. Brotherthe Clone" (Nov. 6). "I think that's how it went/' Caplan said. "It fell into a Theeditorialist pointed out that the purpose of Hall's groundwhere Jurassic Park precededit - and the groundwas experiment is to help infertile couples become parents fertile'' for scary scenarios. by increasingthe number of fertilizedembryos available ''Why did it get to silly so fast? People don't know much forimplantation in the wife's uterus. about cloning and reproductive technology andgenetics, and ''Thework is farfrom finished, and... manyphysi­ that includes the mediaand even the experts who comment'' cians and bioethicists think thatnow,·not later, .isthe on it to thepress. Even among bioethicists,Caplan said, there timefor debate," theeditorial says. "Separatingthe-big are very few who know enough to say very much about questionsfrom theis trivial important. Butsio, too, is the genetics. -fact thatcloning embryosmay make it easier for thou­ Anti-abortionists Played a Role �ds of couples to realize theirdream of giving birth. T6 stopthe research,now would be todo them a cruelty, Another reason for the brouhaha, he added, is that many reasonenough to hopethe ,researchers ••• will .continue whooppose cloning share strong a right-to-life background: theirwork.'' ''What you do to embryos,'' he explained, ''is a major January 1, 1994 Page5 New Paradigm Links Genes andViolence

A provocativenew �ding, basedwide on but preliminary behavior believe the implications of their findings are liberat­ data, has for the first time linked genetic factors and ing, not threatening.'' He adds: environmentalforces in anexplanation of aggression,violence, ''In demonstrating that self-controland impulsiveness may andcrime. be regulatedby brainchemistry and genes, theirresearch chal­ This paradigm says that aggressivity against one's self or lengesthe ooncept that violent crime is theresult of an evilwill; others, and the violence that can result, are mediated by the ratherit placesaggressive violence in thesame categozy � depres­ neurotransmitters serotonin and noradrenaline, and perhaps sion,schizophrenia and other #mental # # disorders.'' other such substances. Low serotonin and high noradrenaline levels, for example, are correlated with aggression and vio- lence, while the opposite situation - high serotoninand low Thisall SOllllds well andgood! Butthe Tribune is a conservative noradrenaline- oftenforeshadows self-satisfaction and social paper in a racially divided city (and nation), and we suspect well-being. ,;:!� thateven Kotulak's benign construct will JX'Ol1lPl angry reactiom. • .... . ,,!·-- · •· .•' ·• �-, --, .-: ·.--·.-· Neurotransmittera1 levels, accordingb to this newunderstand- _ • nt��'._"' : : :7e: � !:�:i,:. ,Vaq:Jne ...... , . familial or social conditions may induce, or activate, these continuedfrom page I genes so that apersonbecomes more aggressive, or losesProzac. self- mllllesystem with only oneor two facetsof the virus, whilethe control. And these personality changes may be permanent, whole virus might stimulate - and do so more strongly - a unlessIdeas Are counte�ted Controversialby drugslike the serotoninbooster halfdo7.en or more immunologicalresponses. The alternative thus might be to vaccinate with live IIlV virusesthat have beenattenuated, so that theycause killed an immu­ This paradigmmay prove to be highly useful - and cer­ nologic reaction but are too weak to cause AIDS or othera tainly will be much discussed in the year ahead. It also is seriousillness. Or, to vaccinate with a whole, virus that highlyprovocative: It postulatesa biological basisfor destruc­ has been inactivated chemically or by othermeans. This is tive and anti-social behaviors which many scientists insist are method favoredby polio vaccine pioneerJonas E. S� M.D., wholly conditioned by environmental factors such as poverty, whoattended the IOM meeting,along withhis son,Peter Salk, brokenhomes, and lack of opportunities. Criticsof theseideas M.D., whoworks with him at theSalk Institute for Biological in theblack community say they areracist (PROBE, April). WholeStudiesin La Viruses Jolla, Cal. Are Feared Public understanding of the new paradigm has been ad­ vanced by a carefully reported, albeit largely uncritical series of articlesby Chicago Tribune sciencewriter Ronald Kotulak; The AIDS establishment has been extremely reluctant to it filledfive broadside pages of thepaper (Dec. 12-15). Kotulak pursue whole-virus AIDS vaccines. Reason: reasonable fear. intervieweda widerange of basic andclinical researchers. He The isfear thatthe organismsmight revert or revive, and cause provided a journalistic synthesis of their thinking thatappears AIDS. For this reason what is more, people might not be to be farbroader and more explicit than the researchersthem­ willing to bevaccinated with themin thefirst place, no matter ------... - -- - "" . --- ,-.�--- selves might acknowledge,given the fearthat their criticsmay how high theirrisk of AIDS. wieldFears enoughDiscounted political clout to cut offtheir grants. Butfederal officials, who fundmuch of thevaccine research, . andmust approveany vaccine before it is _used,are shifting their·· views. The fed's point man forAIDS research, Anthony S. Kotulak cites the "fears" that some groups - meaning, Fauci, M.D., of the National Institutes of Health, said thatan obviously, blacks- ''will be stigmatized asviolence-prone.'' attenuated whole virus ''may ultimately bethe answer to the But, he stresses, ''researchers emphasize that genes linked to vaccine thing.'' killed aggr5ionare foundall in racial and ethnic groups.'' This brought a smile to the face of polio vaccine developer The Tribreporter says that ''most of thosewho studyviolent Salk. Hefavors a whole, virus,rather than live, a attenu­ Provocative Headlines atedone. But he has beenone of the fewwho have arguedin recentFDAyears Shifts forthe Views whole-virus approach.

Theseare the Page one headlines in the Chicago Tribune's series"Tracking''Unlocking down the mind'' themonster (Dec. 12-15) within on us" thebiological TheU.S. Foodand Drug Administration now(FDA) is inter­ roots"Howof violence: brain's chemistry unleashesviolence" ested in this approach, too. Thedirector of FDA's Center for "Whysome kids tum violent: Abuseand neglect BiologicsEvaluation and Research, the office that wouldassess can resetbrain's che111istry" sucha preparation, warnedthat it will be "difficult" totrans­ "Newdrugs break spell of violence" late researchfindings in this realm intouseful products. But, saidbiologist Kathryn Zoon, Ph.D.: ''We've put thatout on thetable to starttalking about it.''

Page6 Probe CriticWarns: fora reporternot to do this, he said. Novelty in Medicine # # # Thekind of storyBarrett wants may takeweeks, or longer,to May Be Bad News researchand write. Mostreporters are given only a fewhours to do a news' story.

Medical news reports in the m� media ought to meet a different -higher -standardthan other news. Kissin Cousins Oft Wed; NutritionThisis Forum,the strongly argued view of a fraud-fightingpsychia­ ttist, Stephen Barrett, M.D., of Allentown, Pa. He is editor of ContraryGenetic to popularDamage opinion, Is population Rare geneticists say, a newsletter that exposes health fads, falla­ marriagesbetween second cousins - which arequite common cies, and quackery. Speaking to science reporters at a recent in the Third World - do not significantly increase their AmericanMedical Association press briefing in Philadelphia, offsprings'burden of damagingand lethal genes. Thesefindings Barrettexplained thatthe higher standardis necessarybecause werepresented the to American �iation for Advancementthe aFraud mistake isin aPossible science story ''may kill a reader.'' of Science (AAAS) lastyear. is Surprisingly, too,declared geneticistAlan H. Bittles, Ph.D., of King's College, London, inbred marriages continue to be News novelty, Barrett said. But in medical reportage popular,despite religiousand legal prohibitions. In fact,Bittles claims fornovel andalternative cures aremore than likely to be said, at a symposium in Boston, there would be more such unsubstantiated,or even outrightfraud. matches,''but thereare just not enough cousins togo around.'' "Most people with [real] breakthroughs don't go around He estimated that afifth of the world's population are the promotingthem,'' he commented. result of first orsecond cousin matings. These pairings have Reporters often qualifystories about health claims by find­ severalsocioeconomic advantages, Bittlesexplained: ing and briefly quoting an expert whodisagrees with the main They areeasy to mange, andusually no dowryis required. news source'sclaim. Barrettrejected this "token balance" as Cousins also tend to marry each other at an early age. This inadequate.Information Is Sparse means that if one of their babies dies in childbirth, there is ample time to conceive anddeliver replacements-an impor­ tant consideration in societiesfirst cousins where healthy, productive off­ "Thesearticles," he said, "rarelycontain enough infonna­ spring areconsidered a sourceof wealthand security. tion to let the reader make an informed decision'' on the Marriages between do have a higher rate of validityof the orcure otherclaim being made. perinatal mortality,due to theinbreeding and the expressionof In Barrett's view, a science reporter's job is to find enough deleterious familial genes, Bittles and other geneticists said. infonnationto allow bothreporter and readers to makea ''crys­ The death rate in these children is about five percent higher talResistance clear judgment" on a... promoter's claim. It's a "cop-out" thanin outbredmarriage. 85% of these women are HIVpositive. So are leastat 18% of their clients. continuedfrom page I Each woman entertains, on average, four menAs a day. This in Kenya-whereto most women whoply theirtrade already are worksout, statistically, to about32 infectiousclients per year; mv positive._,. have had dozens or more unprotected sexual each exposure carries a 1.5% risk of infection. theresult, exposures infectedmen. But theyremain uninfected. about 40% of these prostitutes- who have been followed • Disappointing findings in existing experimental drug and carefully since 1985 -becomeHIV infected each year. vaccine development programs have discouraged the AIDS But a handful of them have not, even after several years. research establishment - the "family" one speaker called Theirbodies harborno virus, and make no.antibody against it; them:mv,- andthey aregrasping for new directions. ''The hopeis their CD4white blood cell ·count,:mv, thestandard madcer formv that something'' accounts for the rare cases of resistance to infection and AIDS, remains nonnal. Yet wiien their blood declared San Francisco public health official Susan specimensare cultured with theyare ''highly infectable,'' Buchbinder,M.D., "andthat we canfind some way to use this Simonsensaid. [factor] toincrease long-tennsurvivals.'' "I'm fascinated, Neil, by youruninfected women!" Levy, This hope, which attracted more than 100 experts to the of San Francisco,declared. meeting, also could be a long shot. Harvard immunologist Simonsenwent on to say,in answerto questions, that abso­ Normanl.etvin, M.D., remarked,wryly: lutelyno differences couldbe found between the infectedand "To saythe least, this is a highly controversialarea!" uninfectedsex workers, by repeatedvaginal examination or by Theclearest and most tantalizing data is on the African"sex anyother means. All practicedvaginal intercourse, but shunned workers,'' asthey now arecorrectly called. Infectiousdisease oral andanal sex, he said Therewere no differencesbetween Januaryspecialist1, J.1994 Neil Simonsen, M.D., from the University of the twogroups in thenumbers of clients,use of condoms, the Manitoba, in Winnipeg, said thatin Nairobi, Kenya, morethan continuedon Pagenextpage 7 ever, that''pro tected'' individuals - whether female prosti­ • • • tutes,'' male homosexuals,or others - are a statistical arti­ Resistance fact: They simply are the farright end of a bell-shaped time o cntinuedfrom page 7 curve foran infection that is bothdifficult to catch andslow to number of pregnancies,nor in the incidence of genital sores or develop into full-blownAIDS. other sexuallytransmitted diseases. They nevertheless may provide important clues. But one innate trait does seem to play a role: invisible "Let's look at theright end of the bell-shaped curve!" Levy immunologic differences in the proteins on the surfaces of said. white blood cells that are called human leukocyte antigens Even given this new research direction, the researchers as­ (HI.A). · There area wide variety of HLA types,as there are red sembled by IOM face this still daunting challenge: The factors bloodcell types such as A, B, and Rh. that might protect people frommv infection,or slow its progres­ Women who possess some of the rarerof the HLA antigens, sion to AIDS, are as yet out ofreach, since the oppositefactors­ such as A6.9, have a significantly lower risk of becoming in­ the ones that cause the disease to progress from exposure, to fectedby mv, Simonsen said. The reason, he indicated, is not infection,to AIDS - still are not known. Said Nobelist molecu­ yet clear. larbiologist David Baltimore, Ph.D., of RockefellerUniversity: He added that, in his view, the women's lack of infection "There is a lack of understanding of what is casual in any was not due to chance alone. Other speakers suggested, how- aspectof [the disease's]progression, at anypoint in time!"

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