Sequence information on viruses collected over time and from different geographical areas can help track evolutionary changes in the virus and identify mutations. It is not, however, presently known which mutations affect the pathogenicity and transmissibility of the virus in humans and thus might signal an altered threat to human health. Epidemiological findings remain the most important alert to changes in the virus that indicate improved transmissibility among humans.

Currently, the genetic sequencing of H5N1 viruses is a product of collaborative work between national or other laboratories receiving specimens in countries with outbreaks and the international network of specialized H5 reference laboratories coordinated by WHO. WHO seeks permission from the country that provides the virus to place the sequence information in the public domain.

WHO believes that timely sharing of H5 virus sequence information is a critical step for improving the international response to the avian and pandemic influenza threat. In its coordinating role, WHO seeks to facilitate the timely release of sequence data to the public domain, such as the Los Alamos National Laboratory (LANL) Influenza Sequence Database and GenBank. Formal procedures exist by which the WHO reference laboratory initially informs the originating laboratory of sequence results and simultaneously requests permission to place these results in the public domain. In the event of a negative reply or no reply, WHO directly approaches the Ministry of Health in the originating country, requesting authorization to release sequence data.

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"Increased Breast Calcifications in Women With ESRD on Dialysis: Implications for Breast Cancer Screening," American Journal of Kidney Disease: Mario Castellanos of the Staten Island University Hospital and colleagues compared the mammograms of 45 women who were on hemodialysis with a control group of 86 age-matched women with normal kidney function (Reuters Health, 8/21). Researchers reported a "statistically significan[t] increase" in the total number of breast calcifications in the group with decreased kidney function, compared with the control group (American Journal of Kidney Diseases, 8/21). Among women in the dialysis group, 84.4% developed breast calcifications, compared with 59.0% of women in the control group, the study finds. The researchers concluded, "Every woman on dialysis therapy should be referred for screening mammography, and the physician taking care of these patients should be aware of the slightly increased risk for workup and possibly resultant psychological stress after screening dialysis patients" (Reuters Health, 8/21). "Tobacco Control Policies: Do They Make a Difference for Low SES Women and Girls?" Journal of Epidemiology and Community Health: Policies that aim to reduce secondhand smoke exposure have been less effective for girls and women of lower economic status than for people of higher economic statues, the report finds. The American Legacy Foundation in the report finds that tobacco control polices have led to a reduction in secondhand smoke exposure for many U.S. residents, and policies such as higher prices have helped to reduce smoking among lower-income women. The report also says women who do not complete high school or who have "blue-collar" jobs are less likely than other women to live in homes without smoke, CQ HealthBeat reports (Abruzzese, CQ HealthBeat, 8/11). "Optimism, Distress, Health-Related Quality of Life, and Change in Cancer Antigen 125 Among Patients With Ovarian Cancer Undergoing Chemotherapy," Psychosomatic Medicine: Janet de Moor of the Ohio State University School of Public Health and colleagues examined the outlook of 90 women with epithelial ovarian cancer at the beginning and end of chemotherapy. De Moor, who conducted the study while at the Dana-Farber Cancer Institute, analyzed the participants' self-reported feelings of optimism and distress, as well as aspects of health-related quality of life among the women, and compared their findings with the women's cancer antigen 125 levels (de Moor et al., Psychosomatic Medicine, 8/1). Decreases in CA 125 levels are used to determine the probability of remission and survival in women with ovarian cancer, Reuters Health reports (Rauscher, Reuters Health, 8/15). According to the study, women who reported higher levels of optimism at the start of chemotherapy experienced greater decreases in anxiety, distress and CA 125 levels than those who reported lower levels of optimism (Psychosomatic Medicine, 8/1). "It is important for health care providers to identify patients who feel less optimistic about life and their cancer and treatment because this population may be vulnerable to distress, diminished quality of life and suboptimum clinical outcomes," de Moor said, adding, "Patients who are less optimistic may benefit from interventions to help them cope with their cancer diagnosis" (Reuters Health, 8/15). This article is republished with kind permission from our friends at the The Kaiser Family Foundation. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery of in-depth coverage of health policy developments, debates and discussions. The Kaiser Daily Health Policy Report is published for Kaisernetwork, a free service of The Henry J. Kaiser Family Foundation. 2006 Advisory Board Company and Kaiser Family Foundation. All rights reserved.