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205
J. Seale, “AIDS Virus Infection: Prognosis and Transmission,”
Journal of the Royal Society of Medicine
78 (1985): 613–15.
206
Using precisely the same reasoning, a right-wing organization based in Orange County, California, concluded that HIV was created by the KGB as part of a plot to take over the United States. The organization favored mandatory quarantine of HIV-positive Americans as the only available measure to stop communist encroachment. See
The Freedom Fighter
, published by the American Information Network of Orange, CA, January 1986. The publication also blamed AIDS on 1959 Nobel Prize recipient Bertrand Russell, saying, “These globalists are responsible for unleashing the AIDS virus upon the world's population, they would be guilty of mass murder at levels heretofore not even conceived of in the most imaginative of monster movies.”
207
U.S. Department of State, “The U.S.S.R.'s AIDS Disinformation Campaign,” Foreign Affairs Note, July 1987.
208
Peter Duesberg's views have been so widely published that it is difficult to narrow a list to key sources. For Duesberg's perspective, see B. Guccione, Jr.,
Interview
, September 1993: 95–108; P. H. Duesberg, “Human Immunodeficiency Virus and Acquired Immunodeficiency Syndrome: Correlation But Not Causation,”
Proceedings of the National Academy of Sciences
86 (1989): 755–64; J. Miller, “AIDS Heresy,”
Discover
, June 1988: 63–68; P. Duesberg, “A Challenge to the AIDS Establishment,”
Biotechnology
5 (1987): 3; and P. H. Duesberg, “Retroviruses As Carcinogens and Pathogens: Expectations and Reality,”
Cancer Research
47 (1987): 1199–1220.
209
For examples of counterarguments to Duesberg's theories, see J. Cohen, “Keystone's Blunt Message: ‘It's the Virus, Stupid,'”
Science
260 (1993): 292; P. Brown, “MPs Investigate AIDS Maverick,”
New Scientist
, June 6, 1992: 9; D. Concar, “Patients Abandon AIDS Drug After TV Shows,”
New Scientist
, July 13, 1991: 13; J. E. Groopman, “A Dangerous Delusion About AIDS,”
New York Times
. September 10, 1992: A23; J. Weber, “AIDS and the ‘Guilty' Virus,”
New Scientist
, May 5, 1988: 32–33; and A. G. Fettner, “Dealing with Duesberg,”
Village Voice
, February 2, 1988: 25–29.
210
See S. B. Thomas and S. C. Quinn, “Understanding the Attitude of Black Americans,” in J. Stryker and M. D. Smith, eds.,
Dimensions of HIV Prevention: Needle Exchange
(Menlo Park, CA: Henry J. Kaiser Family Foundation, 1993), 99–128.
211
Estes (1991), op. cit., 489–558.
212
A. J. Pinching, “AIDS and Africa: Lessons for Us All,”
Journal of the Royal Society of Medicine
79 (1986): 501–3.
213
Karpas (1990), op. cit.
214
B. Evatt, D. P. Francis, and M. F. McLane, “Antibodies to Human T Cell Leukemia Virus-Associated Membrane Antigens in Haemophiliacs: Evidence for Infection Before 1980,”
Lancet
II (1983): 698–700.
215
Centers for Disease Control, “Recommendations for Counseling Persons Infected with Human T-Lymphotropic Virus, Types I and II,”
Morbidity and Mortality Weekly Report
42 (1993): 1–7.
216
C. Bartholomew, C. Saxinger, J. W. Clark, et al., “Transmission of HTLV-I and HIV Among Homosexual Men in Trinidad,”
Journal of the American Medical Association
257 (1987): 2604–8.
217
H. Lee, P. Swanson, V. S. Shorty, et al., “High Rate of HTLV-II Infection in Seropositive IV Drug Abusers in New Orleans,”
Science
244 (1989): 471–77.
218
P. S. Sarma and J. Gruber, “Human T-Cell Lymphotropic Viruses in Human Diseases,”
Journal of the National Cancer Institute
81 (1990): 1100–6.
U.S. prostitute surveys showed HTLV-II incidence was highest among those women who were injecting drug users. See R. F. Khabbaz, W. W. Darrow, T. M. Hartley, et al., “Seroprevalence and Risk Factors for HTLV-I/II Infection Among Female Prostitutes in the United States,”
Journal of the American Medical Association
263 (1990): 60–64. By 1991 the U.S. blood-bank industry conceded that both HTLV viruses had contaminated the American blood supply. See M. T. Sullivan, A. E. Williams, C. T. Fang, et al., “Transmission of Human T-Lymphotropic Virus Types I and II by Blood Transfusion,”
Archives of Internal Medicine
151 (1991): 2043–48.
219
Serwadda's group noted that in 1985 “the first recognized cases came from a small village on Lake Victoria, just north of the Tanzanian border. This village was one of many from which goods were traded across the border. The notion that the disease may have been transmitted sexually from Tanzania is interesting since it fits historically with the movements of the Tanzanian Army … and subsequent regular visits by the Tanzanian traders. Of the 15 traders tested for evidence of HTLV-III [HIV] antibodies, 10 were positive … . There have been no studies as yet to show whether the virus is endemic in Tanzania and, if so, whether it has been introduced from Uganda via traders and soldiers.” See Serwadda, Mugerwa, and Sewankambo, (1985), op. cit.
12. Feminine Hygiene
1
N. Friedman, “Everything They Didn't Tell You About Tampons,”
New West
, October 20, 1980: 33–42; and R. E. Wheatley, M. F. Menkin, E. D. Bardes, and J. Rock, “Tampons in Menstrual Hygiene,”
Journal of the American Medical Association
192 (1965): 113–16.
2
In 1977 a medical team from the University of Colorado Medical Center in Denver reported treating four young women (two of whom were teenagers) for vaginal ulcers, apparently caused by tampons. Two of the cases involved the so-called deodorant products (actually perfumed, rather than deodorized). All four women healed with cessation of tampon use. See K. F. Barrett, S. Bledsoe, B. E. Greer, and W. Droegemueller, “Tampon-Induced Vaginal or Cervical Ulceration,”
American Journal of Obstetrics and Gynecology
127 (1977): 332–33.
3
The industry denied allegations that asbestos was ever used in their products, but also consistently refused to list the stabilizing fibers that were used to prevent the cotton tampons from falling apart.
4
D. E. Marlowe, R. M. Weigle, and R. W. Stauffenberg, “Measurement of Tampon Absorbency: Evaluation of Tampon Brands,” Bureau of Medical Devices, U.S. Food and Drug Administration, Rockville, MD, 1981.
5
In her outstanding piece of investigative journalism, Nancy Friedman notes: “The range of blood loss during menstruation is two to six ounces. A single superabsorbent tampon is capable of soaking up an ounce or more of fluid. Since menstruation is a gradual process lasting three to seven days, the question arises: If the tampon has absorbed all the blood leaving the uterus and still hasn't reached saturation, what will it absorb? The answer: the normal secretions of the healthy vaginal walls.” Friedman (1980), op. cit.
6
M. Chrapil et al., “Reaction of the Vagina to Cellulose Sponges,”
Journal of Biomedical Materials Research
13 (1979): 1.
7
A. Johnson, “Used Carboxymethyl Cellulose as Chromatographic Purifier for
Staphylococcal
Toxins,”
Infection and Immunology
25 (1979): 1080–85.
8
K. F. Barrett, “Tampon-Induced Ulceration,”
American Journal of Obstetrics and Gynecology
127 (1977): 332; R. K. Collins, “Tampon Induced Vaginal Laceration,”
Journal of Family Practice
9 (1979): 127; and F. K. Beller, “Vaginal Tampon as Drug Carrier,”
Medical World
30 (1979): 709.
9
J. P. Davis, J. Chesney, P. J. Wand, et al., “Toxic-Shock Syndrome,”
New England Journal of Medicine
303 (1980): 1429–35.
10
J. Todd, M. Fishaut, F. Kapral, and T. Welch, “Toxic-Shock Syndrome Associated with Phage-Group-I Staphylococci,”
Lancet
II (1978): 1116–18.
11
F. Stevens, “The Occurrence of
Staphylococcus aureus
Infection with a Scarlatiniform Rash,”
Journal of the American Medical Association
88 (1927): 1957.
12
H. Aranow and W. B. Wood, “Staphylococcal Infection Stimulating Scarlet Fever,”
Journal of the American Medical Association
119 (1942): 1491.
13
T. Kawasaki, “Acute Febrile Mucocutaneous Syndrome with Lymphoid Involvement with Specific Desquamation of the Fingers and Toes in Children,”
Japanese Journal of Allergology
16 (1967): 178–222.
14
Between 1975 and 1980 over 10,000 cases of Kawasaki syndrome were diagnosed in Japan.
15
Centers for Disease Control, “Toxic-Shock Syndrome—United States,”
Morbidity and Mortality Weekly Report
29 (1980): 229–30.
16
See Table 1 in K. N. Shands, G. P. Schmid, B. B. Dan, et al., “Toxic-Shock Syndrome in Menstruating Women,”
New England Journal of Medicine
303 (1980): 1436–42.
17
Centers for Disease Control, “Follow-up on Toxic-Shock Syndrome,”
Morbidity and Mortality Weekly Report
29 (1980): 441–45.
18
The CDC's results were:
Cases
Controls
Tampon Brand
(N = 42)
(
N = 114)
Rely
71%
26%
Playtex
19%
25%
Tampax
5%
25%
Kotex
2%
12%
OB
2%
11%
19
Food and Drug Administration, News Release PBD-42, September 25, 1980.
20
Centers for Disease Control, “Toxic-Shock Syndrome—Utah,”
Morbidity and Mortality Weekly Report
29 (1980): 495–96.
21
D. B. Petitti, A. Reingold, and J. Chin, “The Incidence of Toxic Shock in Northern California,”
Journal of the American Medical Association
255 (1986): 368–72.
22
According to the manufacturers, prior to 1977 all tampons were made primarily of rayon and cotton. After 1977, however, 65 percent of all tampons sold in the United States contained polyacrylate fibers, carboxymethyl cellulose, higher-absorbency rayon-cellulose, polyester, or other synthetics.
23
R. W. Tofte, K. B. Crossley, and D. N. Williams, “Clinical Experience with Toxic-Shock Syndrome,”
New England Journal of Medicine
303 (1980): 1417.
24
“Report Rise in Toxic Shock Cases Unrelated to Tampon Use,”
Hospital Practice,
July 1982: 197–200;
“S. aureus
Bacteriophage May Be Implicated in Toxic Shock,”
Hospital Practice,
May 1983: 36–38; and B. Hanna and P. Tierno, “Staphylococcal Growth on Carboxymethyl Cellulose,” presentation to the Annual Meeting of the American Society of Microbiology, 1981.
25
It is likely that true
Staphylococcus
rates were 100 percent. As physicians became more familiar with TSS and recognized the speed with which the ailment could dangerously escalate, it became routine to give symptomatic menstruating females high doses of non-penicillinase antibiotics before taking vaginal samples and awaiting staph culture results.
26
Davis et al. (1980), op. cit.
27
These and many other comments in this chapter were made to the author during interviews conducted over the course of the TSS investigation.
28
J. Langone, “Riddle of the Tampon,”
Discover
, December 1989: 26–28.
29
P. M. Schlievert, K. M. Bettin, and D. W. Watson, “Purification and Characterization of Group A Streptococcal Pyrogenic Exotoxin Type C,”
Infection and Immunology
16 (1977): 673–79.
30
P. Schlievert, “Activation of Murine T-Suppressor Lymphocytes by Group A Streptococcal and Staphylococcal Pyrogenic Exotoxins,”
Infection and Immunology
28 (1980): 876–80.
31
Institute of Medicine, “Toxic Shock Syndrome: Assessment of Current Information and Future Research Needs” (Washington, D.C.: National Academy Press, 1982).
32
By that time Schlievert and his collaborators in Minnesota, Wisconsin, Colorado, and California were seeing clear autoimmune disorders in the women who had survived TSS bouts months earlier. Eleven of 123 women surveyed had developed lupus, and 40 percent had early symptoms of arthritis—a striking finding given that most TSS sufferers were under thirty-five years of age.
P. M. Schlievert, K. M. Shands, B. B. Dan, et al., “Identification and Characterization of an Exotoxin from
Staphylococcus aureus
Associated with Toxic-Shock Syndrome,”
Journal of Infectious Diseases
143 (1981): 509–16; and P. M. Schlievert and J. A. Kelly, “Staphylococcal Pyrogenic Exotoxin Type C: Further Characterization,”
Annals of Internal Medicine
96 (1982): 982–86.
33
Centers for Disease Control, “Toxic Shock Syndrome, United States, 1970–1982,”
Morbidity and Mortality Weekly Report
31 (1982): 201–4.
34
Centers for Disease Control, “Update: Toxic-Shock Syndrome—United States,”
Journal of the American Medical Association
250 (1983): 1017.
35
A. L. Reingold, “Epidemiology of Toxic-Shock Syndrome, United States, 1960–1984,”
Morbidity and Mortality Weekly Report
33 (1982): 19ss—22ss.
36
When averaged over the population as a whole for the various states, acute TSS cases occurred, for example, in:
State
Per capita (all ages
,
both genders
)
Utah
1:10,288
Minnesota
1:14,201
Wisconsin
1:17,363
Colorado
1:22,228
Oregon
1:30,978
Ohio
1:73,956
Washington
1:93,917
Indiana
1:99,368
California
1:100,713
Michigan
1:110,262
Texas
1:122,633
New York
1:532,065
Based on cumulative reports, 1975–83, to the CDC.
See Petitti, Reingold, and Chin (1986), op. cit.
37
S. F. Berkley, A. W. Hightower, C. V. Broome, and A. L. Reingold, “The Relationship of Tampon Characteristics to Menstrual Toxic Shock Syndrome,”
Journal of the American Medical Association
258 (1987): 917–20.
38
G. Faich, K. Pearson, D. Fleming, et al., “Toxic Shock Syndrome and the Vaginal Contraceptive Sponge,”
Journal of the American Medical Association
255 (1986): 216–18; and A. L. Reingold, “Toxic Shock Syndrome and the Vaginal Sponge,”
Journal of the American Medical Association
255 (1986): 242–43.
39
S. M. Wolfe, “Dangerous Delays in Tampon Absorbency Warnings,”
Journal of the American Medical Association
258 (1987): 949–51.
40
The chart was as follows:
Absorbency
Ranges of Absorbency in Grams
Tampons come in the following standardized industry-size absorbencies.
Junior absorbency
Less than 6
Regular absorbency
6 to 9
Super absorbency
9 to 12
Super Plus absorbency
12 to 15
41
L. E. Markowitz, A. W. Hightower, C. V. Broome, and A. L. Reingold, “Toxic Shock Syndrome: Evaluation of National Surveillance Data Using a Hospital Discharge Survey,”
Journal of the American Medical Association
258 (1987): 75–78.
42
K. L. MacDonald, M. T. Osterholm, C. W. Hedberg, et al., “Toxic Shock Syndrome: A Newly Recognized Complication of Influenza and Influenzalike Illness,”
Journal of the American Medical Association
257 (1987): 1053–58; and Centers for Disease Control, “Toxic Shock Syndrome Associated with Influenza,”
Morbidity and Mortality Weekly Report
35 (1986): 143–44.
43
S. J. Sperber and J. B. Francis, “Toxic Shock Syndrome During an Influenza Outbreak,”
Journal of the American Medical Association
257 (1987): 1086–87.
Langmuir and his colleagues hypothesized the existence of such a scourge, combining TSS and influenza, which they dubbed Thucydides syndrome after the great Greek chronicler, and said might have been the cause of the 430–427 B.C. plague of Athens. See A. D. Langmuir, T. D. Worthen, J. Solomon, et al., “The Thucydides Syndrome: A New Hypothesis for the Cause of the Plague in Athens,”
New England Journal of Medicine
313 (1985): 1027–39; and B. B. Dan, “Toxic Shock Syndrome: Back to the Future,”
Journal of the American Medical Association
257 (1987): 1094–95.

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