Chinese scholars call for AIDS rules based on respect for individual rights

In June 2002, the UN Theme Group on HIV/AIDS in China published a comprehensive situation analysis and needs assessment of the HIV/AIDS epidemic in the People's Republic of China (PRC). The report, entitled "HIV/AIDS: China's Titanic Peril", also describes and analyzes current HIV/AIDS legislation and policies. It notes that "laws and regulations that are based on fear and prejudice have contributed to fuelling the epidemic instead of curbing it." The report observes that the targets and goals established in China's five-year Plan of Action (2001-2005) are not consistent with the commitments endorsed in June 2001 at the United Nations General Assembly Special Session on HIV/AIDS. It states that the Plan "continues to present HIV/AIDS as a medical problem, and fails to understand the epidemic as a broader development issue." Even where laws could assist, enforcement remains a huge challenge. For example, in 1998 the National People's Congress passed a law prohibiting commercial blood donations for medical purposes. Nonetheless, the illicit and unregulated blood trade, which has rapidly accelerated the spread of HIV infection in China, has continued. When the alarm was sounded by Dr. Wan Yanhai, coordinator of the AIZHI (AIDS) Action Project, the government response was to arrest him. In the following article, Nick Young, editor of China Development Brief, reviews the findings of three studies commissioned by the United Nations Development Programme (UNDP) on the role of the law in response to HIV/AIDS.     

Fatal child abuse-maltreatment syndrome. A retrospective study in Ontario,Canada, 1990-1995

Child death due to repeated episodes of physical assault or neglect has been termed the child abuse-maltreatment syndrome (CAMS). We characterized the injuries in a series of fatally abused or maltreated child to delineate objective diagnostic criteria for the CAMS for use by clinicians and pathologists. All deaths (age <17 years) investigated by the Office of the Chief Coroner for Ontario, Canada during the time period 1990-1995 were reviewed. Cases of CAMS were defined as death due to lethal recent injury or malnutrition in the presence of significant old (healing or healed) injuries indicative of repeated episode of inflicted trauma. The nature and frequency of the various injuries was determined. The frequency of the shaken baby syndrome, and the types and frequency of ano-genital injuries were also studied. Twenty-one cases of fatal CAMS were found in the study period. Most cases had significant recent head injury with intra-cranial hemorrhage (71%). Other significant recent injuries commonly observed included blunt injuries of the skin and soft tissues (67%), blunt abdominal trauma with visceral injuries (14%), and fractures (18%). Eight cases (38%) fulfilled accepted criteria for the shaken baby syndrome. Many children with fatal head injuries had evidence of older head trauma (38% of all cases). A significant minority of cases had evidence of malnutrition due to neglect (10%) or ongoing ano-genital injuries (10%). Most cases of child homicides due to repeated episodes of abuse or maltreatment involve head trauma including shaken baby syndrome. Fractures of long bone and ribs, the classical markers of child abuse, were relatively infrequent compared with head injury. A proportion of cases had ano-genital injuries due to repeated sexual abuse or punitive maltreatment. All clinicians and pathologists must recognize the wide spectrum of injuries in child abuse to ultimate protect the victim or other children in an at-risk situation.     

Sudden death in a neonate as a result of herpes simplex infection

This paper describes a case of a neonate with disseminated herpes simplex born to a 14-year-old asymptomatic mother. The infant's physical examination was normal at birth, and subsequent abnormalities were so subtle that infection was not recognized during life. Postmortem cultures of liver and spleen grew herpes simplex virus, and immunofluorescent direct antibody typing revealed Type 2. A cervical culture of the mother obtained after the infant's death was negative.