MDR-TB responds poorly to standard treatment because of resistance to the first-line drugs isoniazid and rifampicin.

It is estimated only 2% of MDR-TB cases worldwide are being diagnosed and treated appropriately - owing mainly to inadequate laboratory services.

The aim is to increase that proportion over the next four years to at least 15%.

The WHO is working on the new initiatives with the Stop TB Partnership, Unitaid, an international drug purchase facility, and the Foundation for Innovative New Diagnostics (Find).

In developing countries most TB patients are tested for MDR-TB only after they fail to respond to a standard treatments.

Even then, it takes two months or more to confirm the diagnosis.

One in 150 people infected with West Nile virus get severe neurological disease. More than 40% of these patients may have serious symptoms for the rest of their lives, say Kristy Murray, PhD, DVM, University of Texas Health Science Center at Houston, and colleagues.

The finding comes from five years of data on 108 Houston-area residents who came down with severe West Nile disease after infection with the mosquito-borne virus. Murray's team evaluated the patients every six months.

A year after their West Nile virus infection, 60% of these patients still had serious symptoms. Five years later, 42% had not fully recovered - and weren't getting any better.

These lasting symptoms included fatigue, muscle weakness, depression, difficulty walking, memory loss, and personality change.

Uganda has 101 suspected cases of Ebola fever and hundreds more people being closely monitored, officials said on Friday, as fear grew in Uganda and neighbouring countries that the deadly virus might spread.

Twenty two people have so far died of the fever and Minister of State for primary health-care Dr. Emmanuel Otaala told journalists 11 health workers have fallen sick.

"Cumulatively, we have 101 cases," he said.

Another 338 people are being monitored because they came into contact with those infected by the virulent haemorrhagic fever, which often causes victims to bleed to death through the ears, eyes and other orifices.

All were in western Uganda's Bundibugyo district, except for two in Kampala, including a doctor who died. Otaala said the cabinet had approved a pay increase to compensate health workers taking on the risk of dealing with Ebola.

"The next pandemic will certainly happen," Margaret Chan told reporters following a forum on the need to improve international health security, noting it was impossible to guess when it might happen or how severe it might be.

Since late 2003, the H5N1 strain of bird flu has prompted the slaughter of millions of birds across Asia and caused the deaths of more than 170 people worldwide, about one-third of them in Indonesia, according to WHO.

The virus has been identified in Europe, Africa and the Middle East, in what Chan called an unprecedented spread.

"We cannot let our guard down," Chan said. "My advice for all member states is to maintain vigilance, to prepare for the pandemic. One thing we know for certain is that any country that is prepared will see less damage."

More than 5 million Americans are living with Alzheimer's disease, a 10 percent increase since the last Alzheimer's Association estimate five years ago and a count that supports the long-forecast dementia epidemic as the population grays.

Age is the biggest risk factor, and the report to be released Tuesday shows the nation is on track for skyrocketing Alzheimer's once the baby boomers start turning 65 in 2011. Already, one in eight people 65 and older have the mind-destroying illness, and nearly one in two people over 85.

Unless scientists discover a way to delay Alzheimer's brain attack, some 7.7 million people are expected to have the disease by 2030, the report says. By 2050, that toll could reach 16 million.

Why? Ironically, in fighting heart disease, cancer and other diseases, "we're keeping people alive so they can live long enough to get Alzheimer's disease," explains association vice president Steve McConnell.

Meanwhile, in this country the new CDC guidelines that now rank pandemics in terms of categories 1 through 5, similar to hurricanes, are making the rounds in the media, and working its way through the government bureaucracy down to the states. The meat of the proposal? if there's a category 4 or 5 pandemic (H5N1 or some other), the schools in your town will close for up to three months, and large public gatherings will be canceled. That's because kids are a major vector in spreading flu and other respiratory diseases (ask any parent of a second grader or day care kid).

Did you know that? Would that affect you or your kids in any way? You bet it would. The task now is to figure out how to mitigate the consequences of such a move. For example, in addition to whether you can afford to stay home, the schools may have to turn to long distance learning. Businesses would have to telecommute where possible. And the kids, now being home and unable to go to the mall, would have to figure out how to entertain themselves.

Any chance thay'd - uh - want to use the internets? And would it be prepared for the onslaught of Kids At Home?

Today's guidelines are partly based on a recent study of how 44 cities fared in the 1918 epidemic conducted jointly by the C.D.C. and the University of Michigan’s medical school. Historians and epidemiologists pored over hospital records and newspaper clippings, trying to determine what factors partly spared some cities and doomed others.

While a few tiny towns escaped the epidemic entirely by cutting off all contact with outside, most cities took less drastic measures. These included isolating the sick and quarantining homes and rooming houses, closing schools, churches, bars and other gathering places, canceling parades, ball games, theaters and other public events, staggering factory hours, barring door-to-door sales, discouraging the use of public transport and encouraging the use of face masks.

The most effective measure seemed to be moving early and quickly. For example, said Dr. Howard Markel, a medical historian and one of the study's leaders, Philadelphia, the worst-hit city, had nearly three times as many sick and dead per capita as St. Louis, which had was hit weeks later by the virus moving inland from the Eastern Seaboard and had time to react as soon as flu cases rose above averages.

"No matter how you set up the model," Dr. Markel said, "the cities that acted earlier and with more layered protective measures fared better."

Scientists have long known that HIV can go dormant, only to emerge again later and run rampant through the body.

"We know the virus can hide out," Weinberger said. "How does it hibernate? We wanted to look at the basic components of the virus."

In the laboratory, the two created a "gutted" HIV virus, or one with molecular components removed. The scientists then looked at the components necessary for the virus to replicate.

Scientists already know that a protein called Tat is connected to HIV's ability to go dormant. After a year of work, the Princeton team identified enzymes that act on the protein. These enzymes modify, or "decorate," the protein. Together, the Tat protein and the enzymes create the cascade of chemical reactions that push HIV in and out of latency.

So far, the scientists have pin-pointed the target, but have no way, at present, to affect it.

Current flu vaccines focus on two proteins on the surface of the virus. However, these constantly mutate in a bid to fool the immune system, making it impossible for vaccine manufacturers to keep up with the creation of each new strain.

The universal vaccines focus on a different protein called M2, which has barely changed during the last 100 years.

The protein is found in all types of Influenza A, including the current bird flu and the virus that caused the 1918 Spanish flu pandemic which killed up to 50 million across the globe.

Normally, such vaccines would have to go through at least five years of human tests before going on the market. However, if a bird flu pandemic occurs before that, they could be made more quickly available.

Zurich-based Cytos, which is also developing anti-smoking and obesity vaccines, has showed that its version of the jab stops mice dying from a dose of flu strong enough to kill them four-times over.

"I might not be with you for a couple weeks," Spearin said. "I missed my birthday. I missed my graduation. I can't remember what I ate yesterday. I can't remember what I did yesterday."

Many times, the disorder appears after a flu-like illness.

Dr. Emanuel Mignot said patients suffer from periodic episodes of extreme sleepiness and abnormal, child-like behavior.

"They feel like they are in a fog," Mignot said. "They don't know exactly the reality around them. If you try to wake them up they are very irritable."

"Mainstream drugs are ineffective against multiple drug-resistant TB," said Nunn. "However, there are half a dozen second-line medicines that can be used to tackle it. Now this new extreme resistant strain has appeared. It is not only resistant to our principal anti-TB drugs, but to many of our second-line defences. In short, we are now on the last line of our defences against tuberculosis."

Among the areas found to have been affected by extreme drug-resistant TB are Latvia and South Africa. Scientists discovered the strain last month among HIV-infected patients in the Kwazulu-Natal region. "Fifty two of the 53 infected people are already dead, and the last may well have died by now," added Nunn.

An estimated 4.5 million people in South Africa have HIV. Extreme drug-resistance TB could devastate the population. "If countries don't have the diagnostic capacity to find these patients, they will die without proper treatment," said Nunn.

As a result, WHO is to hold its emergency meeting in Johannesburg to help establish measures that will lead to the rapid diagnosis of the new strain.

But herpes is still uncomfortably common. Despite the decline, blood tests of more than 11,000 people found 11 percent of men and 23 percent of women carry the genital herpes, or type 2, virus. Among people in their 20s, the infection rate was almost 11 percent.

Ironically, the rates have dropped back to about where they were when Time ran its cover story, said study co-author Dr. Stuart Berman of the CDC.

"If it was a scarlet letter then, I don't know what you call it now and there’s more HIV around," Berman said. Herpes greatly increases the chances of infection with HIV, the virus that causes AIDS.

"It's still an epidemic," said Dr. Tom Cherpes of the University of Pittsburgh School of Medicine, who was not involved with the study. "The fact that there’s a trend downward should not be construed by anybody that herpes is under control."

Despite infection rates that are ravaging Africa and other parts of the developing world, Bill Clinton and Bill Gates insisted Monday a "happy ending" is in the offing and AIDS will be vanquished.

The former U.S. president and the Microsoft chairman conceded at the International AIDS Conference Monday the turning point in the pandemic has not yet been reached and may not come until scientists develop a vaccine or some other form of preventive tool. Clinton, whose charitable foundation is largely focused on the HIV/AIDS cause, said visiting endemic regions gives him optimism for a AIDS-free future.

On a recent trip to Liberia, a country nearly destroyed by civil war, the college students he met were as bright and ambitious as any he has encountered.

"The source of optimism is the human material," he said. "There is no shortage of intelligence, effort, dreams and drive anywhere in the world."

On April 28, Devin Adair, a healthy, 21-year-old tight end for the University of Tulsa's football team, mysteriously died after spending a week in the hospital.

While it was obvious that he was very ill, he had no visible wounds to help doctors ascertain what was wrong.

When the autopsy report came back last week, the pieces of the puzzle came together: Flesh-eating bacteria had killed him.

Also known as necrotizing fasciitis, flesh-eating bacteria are potent enough to turn a wound as minor as a pinprick or paper cut into a massive infection causing amputation or even death. In Oklahoma, Adair's death is the latest of about a dozen people who have died from the infection since 2003.

PHASE ONE
Inter-pandemic phase -- Low risk of human cases.

PHASE TWO
New virus in animals, but no human cases -- Higher risk of human cases

PHASE THREE
Pandemic Alert -- No or very limited human-to-human transmission

PHASE FOUR
Clusters of human cases suggesting increased adaptability of the virus -- Evidence of increased human-to-human transmission

PHASE FIVE
Larger clusters of human cases over longer periods -- Evidence of significant human-to-human transmission

PHASE SIX
Pandemic -- Efficient and sustained human-to-human transmission

Also today, the WHO reiterated that it will not raise its global pandemic alert level from phase 3 (human infection, but no or only rare human-to-human spread) to phase 4 (small clusters with limited human-to-human transmission, but spread is highly localized). The agency said this week that human-to-human-to-human (two-generation) transmission might have occurred in the North Sumatra cluster. But officials have observed no further spread beyond the family cluster and no ominous mutations in H5N1 viruses that have been analyzed.

Paul Gully, senior adviser to WHO's top avian flu official, Margaret Chan, said in a third Reuters report, "Our feeling now is there is nothing new that has happened which would make us want to consider moving to level 4."

Patients say that's the worst symptom — strange fibers that pop out of your skin in different colors.

"He'd have attacks and fibers would come out of his hands and fingers, white, black and sometimes red. Very, very painful," said Lisa Wilson, whose son Travis had Morgellon's disease.

While all of this is going on, it feels like bugs are crawling under your skin. So far more than 100 cases of Morgellons disease have been reported in South Texas.

"It really has the makings of a horror movie in every way," Savely said.

While Savely sees this as a legitimate disease, there are many doctors who simply refuse to acknowledge it exists, because of the bizarre symptoms patients are diagnosed as delusional.

The fact that the travelers touched down mainly in the Midwest probably explains why that region is suffering the most. (Coincidentally, the last big mumps epidemic, in the 1980s, also centered on the Midwest.) So far, Iowa has been hit the hardest; it would only see five mumps cases in a normal year, but the state accounts for more than 800 of this year's 1,100-odd victims. In Waterloo, Iowa, Buschkamp's hometown of about 70,000 people, even the mayor has the mumps. Kansas, Illinois, Minnesota, Wisconsin, Oklahoma, Indiana and Nebraska have all also confirmed that the same mumps strain is circulating there.

The outbreak started with older victims and can target people of any age--Sharon Watson of the Kansas Department of Health and Environment says her state has seen cases "from age 5 to age 90"--but it has largely hit young, otherwise healthy college students. Almost 35 percent of the early cases occurred in 19-year-olds. Mumps is spread by coughing and sneezing, and victims also are contagious for three days before they develop symptoms, so the close quarters of college are a naturally vulnerable site for the virus to spread. "This happened on spring break, and it's very easy to unwittingly spread it," Watson says. If the disease hasn't retreated by summer, kids leaving school could cause another wave of infection in parts of the country that thus far remain unaffected.

Once a rite of passage in childhood, mumps was largely tamped down in the 1960s with the advent of a vaccine, and it hasn't been a major public health problem for two decades. Epidemiologists think several factors may have caused its return. On is that the measles, mumps and rubella shot needs to be given twice in order to be most effective, and some parents are neglecting to take their child in for the second treatment. Another is that some parents, responding to fears that the vacines could be linked to autism, are simply not getting the shots at all for their children. "Lots of pediatricians have bemoaned the fact that parents are either not paying attention or [are] actually opposed to vaccination," says Dr. John Baldwin, president of the CBR Institute for Biomedical Research, a Harvard-affiliated immunology center. Many states require full double vaccination for entry into any state school, but a significant number of students in Iowa started college before that requirement took effect in the early 1990s. And even double vaccination doesn't take care of everything; about 10 percent of kids who go through it still end up getting mumps.

Dr Chan told over 30 experts in Geneva that the agency's top priority was to keep the deadly H5N1 strain of bird flu from mutating.

"Should this effort fail, we want to ensure that measures are in place to mitigate the high levels of morbidity, mortality and social and economic disruption that a pandemic can bring to this world," she said.

WHO says 175 people are confirmed to have caught bird flu, and 95 of them have died.

Global influenza pandemics - as opposed to annual recurrences of seasonal flu - tend to strike periodically. In the 20th century, there were pandemics in 1918, 1957 and 1968.

Bird flu could potentially cause more deaths than those from the global flu pandemics. Because the H5N1 virus is airborne, it is easier to transmit and more contagious than HIV/AIDS, WHO officials said.

"It is a very exciting discovery," said Dr. Eric Klein of the Cleveland Clinic, who will present the findings Friday at an American Society of Clinical Oncology prostate symposium in San Francisco. "There is now a suggestion that prostate cancer could be caused by an infectious disease."

Infectious disease-causing viruses are already blamed for causing some liver cancers and cervical cancer. That has planted nagging suspicions in the minds of scientists that some diseases may play important roles alongside genetics, environment and chance in causing breast, stomach and several other forms of cancer.

Researchers are not sure how the virus infected people, but suspect it has been passed on genetically for thousands of years.

"This is a class of virus no one would have looked for in prostate cancer," said UCSF researcher Joe DeRisi, who developed the so-called "gene chip" that made the discovery. DeRisi's chip contains 20,000 snippets of vital genetic material from every known virus. It is the same chip that confirmed a previously undiscovered virus in the cold family that caused the SARS outbreak three years ago.

The "chikungunya" disease, which is extremely painful and causes high fever, was not previously thought to be lethal and there is no known cure or vaccine.

The Reunion Regional Agency for Hospitalisation said late on Friday the virus was the only explanation for the death of a nine-year-old in January.

The "chikungunya" fever is named after a Swahili word meaning "that which bends up," referring to the stooped posture of those afflicted.

First recognised in epidemic form in East Africa in 1952, it also leaves immune systems weak, providing opportunities for other diseases to set in.

A 54-year-old woman from the town of Raniya is thought to be the most serious of the suspected cases.

Iraqi officials say a teenage girl died of the strain two weeks ago.

Shanjin Abdel Qader died in a hospital in the nearby city of Sulaimaniya on 17 January, after an illness lasting 15 days.

Initial test results from a WHO laboratory were negative, but after Iraqi tests showed indications of H5N1 the organisation agreed to a further examination in a UK laboratory.

Lead researcher Dr Robert Ménard said only fully developed parasites can infect red blood cells and cause malaria - so the lymph-node parasites probably do not contribute to the appearance of malaria symptoms.

However, he said even partially developed or destroyed parasites could significantly affect how the immune system responds to infection.

Parasites developing in the lymph nodes might alert the body that an invader is present, and activate a protective immune response.

Alternatively, their presence might desensitise the body to the parasites, blunting the immune system's response to infection.

Influenza has become widespread in the Southwestern United States, though health officials Friday still classified the disease's spread this winter as fairly typical.

Seven states -- California, Nevada, Arizona, New Mexico, Utah, Colorado, and Texas -- now show what scientists classify as widespread flu activity. The number is up from four states two weeks ago, according to data released by the CDC.

In all, the agency has received 63,104 reports of persons contracting flu-like illness as of Dec. 31, placing the 2005-2006 flu season at about average for yearly U.S. flu activity.

"Basically, activity is increasing as you'd expect for this time of year. This [season] is lighter than some, but activity is staring to pick up," says Lynnette Brammer, an epidemiologist who oversees domestic flu surveillance for the CDC.

Muntasir Mohamed Osman, a senior health ministry official, said there were 299 suspected cases of the mosquito-borne disease in the affected South Kordofan region in central Sudan.

Most of the cases which were arriving at hospitals in the rural and mountainous area were at a terminal stage, leading to an unusually high death rate of almost 25 percent.

"There is no vaccine or cure for dengue," he told Reuters. "We can treat the symptoms only."

State health officials have confirmed a fifth case of polio virus infection in an Amish child in central Minnesota, the Minnesota Health Department said Wednesday.

The child's family is unrelated to two families with children who have tested positive for the virus, said Doug Schultz, a Health Department spokesman. The families are all part of the same Amish community near Clarissa.

An Amish elder said he has decided to have his children vaccinated. He said he is doing what he can and will leave the rest in God's hands.

Minnesota's top doctors have been urging Amish around the state to get their children immunized.

The mystery has deepened in recent weeks. Only at the end of May did local health officials see a second elderly woman die of the incurable disease involving a malformed protein, or prion, that kills brain cells. After that, they learned of three other suspected cases, including a CJD death in February that was reported only last month.

vIs what is happening in Idaho an anomaly, a statistical fluke? That is possible," said Ermias Belay, a top CJD expert with the Centers for Disease Control and Prevention in Atlanta who is helping advise officials in Idaho. "But once it exceeds 1.5 or 2 per million, you start asking questions."

"If they are all confirmed, it could be odd."

In a year, the United States typically sees fewer than 300 CJD cases, which mete out rapid death to the elderly, according to the Centers for Disease Control.